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Welcome, Florida Healthcare Providers

Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.

As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.

If you have any questions, please call Provider Services at 1-855-322-4076.

Medicare Crossover Claims Policy Change

Effective October 25, 2016, Molina Healthcare of Florida, Inc. ("Molina"), in collaboration with the Agency for Health Care Administration ("AHCA"), will begin accepting crossover claims from the Centers for Medicare and Medicaid Services ("CMS") for dual-eligible, Molina Medicaid members covered by traditional, fee-for-service Medicare. Providers will no longer be required to submit secondary claims to Molina, as the claim will cross over automatically.

This change does not apply to Molina Medicaid members enrolled in a Medicare Part C (Medicare Advantage) plan. Providers must continue to file secondary claims to Molina for these members. 

If you have any questions about this communication, please contact Provider Services at (855) 322-4076.

Service Location Requirement for Professional Claims

In order to ensure appropriate reimbursement of professional claims for providers whose contracted fees are based on Medicare rates, Molina Healthcare of Florida will now require service locations on the CMS-1500 form, box 32, and its electronic equivalent.

Medicare rates are determined, in part, by the specific locality in which a service is rendered. Therefore, the service location must be included on the claim to ensure that the correct locality rate is selected during claims adjudication, and reduce miscalculated payments.

If your rates are based on a percentage of Medicare's fee schedule for any contracted line of business, including Medicaid and Marketplace, you must include service locations on your claims as of March 1, 2017. Failure to include service locations on your professional claims may result in claims denials.

If you have any questions regarding this communication, please contact Provider Services at 855-322-4076.​

Provider Services Portal

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Molina’s Provider Self Services has a variety of tools to simplify your transactions whether you need to check eligibility or check claim status. For more information contact Provider Services. Molina Healthcare is now collecting National Provider IDs (NPIs) from contracted and non-contracted providers. Submit your NPI to Molina via our Provider Self-Services Portal.

Important Reminder:

It is important to Molina Healthcare and your patients that your provider directory demographics are accurate. Please visit our Provider Online Directory at: providersearch.molinahealthcare.com to validate your information and notify us if there are any updates.

Please notify Molina Healthcare at least 30 days in advance when you have any of the following:

  • • Change in office location,
       office hours, phone, fax, or email
  • • Addition or closure of office location
  • • ​Addition or termination of a
       provider
  • • Change in Tax ID and/or NPI
  • • Open or close your practice to new
       patients (PCPs only)
Doctor

First Steps in Taking Care of Your Diabetes

Simple Steps to Manage Diabetes

Providers

Molina's MMA Physician Incentive Program

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LTSS Quick Reference Guide

Looking for information about requesting authorization or submitting a claim for Long-Term Services and Supports? Learn more.​

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