“I love working with Molina, their claim department is responsive and efficient”
Dr. Marina Jones
The Provider Services Department has dedicated Provider Service Representatives (PSRs) to assist your office. PSRs are available to offer training, conduct visits to provider offices, help with Provider Portal registration, answer questions and serve as the point of contact for all provider needs.
The below link to the PSR Territory Map reflects the specialty area (Behavioral Health, Long Term Care Support Services and Physical Health), the PSRs and Supervisors responsible for each of these areas and their contact information. Please contact them for any assistance that your office requires. Molina Healthcare Provider Services
Molina Health Care of New Mexico, Inc. is pleased to participate with the New Mexico Health Information Collaborative (NMHIC), a secure electronic health care information system that allows participating providers to access patient health care information in real time. The Health Information Exchange (HIE) network is designated through the state to connect unrelated heath care systems and providers to be able to access patient records electronically, securely and privately with the patient’s consent. Providers can access the most up-to-date lab results, medical history and test information to be more prepared when working closely with the patient in making health care decisions.
HIE increases patient safety by having timely access to medication lists, emergency department visits, radiology and laboratory results, as well as facility admission and discharge details to have a more concise and comprehensive patient medical record. Patient health information is shared following federal guidelines in accordance with the Health Insurance Portability and Accountability Act (HIPAA). For more information, visit the New Mexico Health Information Collaborative website at www.nmhic.org
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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 please reference the Web Portal Quick Reference Guide or 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.
The New Mexico Alliance for School-Based Health Care represents school-based health centers in New Mexico and collaborates with other partners to promote, facilitate, and advocate for comprehensive, culturally competent health care, including health education, in schools. Click here to learn more about the exciting happenings at School-Based Health Care Centers across the State.
Please notify Molina Healthcare at least 30 days in advance when you have any of the following:
Molina Healthcare of New Mexico, Inc. is pleased to announce a partnership with Home Medical Equipment Specialists (HME Specialists) for durable medical equipment and home medical supplies state wide. Click here
The OIG has issued guidance to providers on how to avoid health care fraud and abuse. Click here to review the recommended OIG guidance.
On February 16, 2012, the Centers for Medicare and Medicaid Services published in the Federal Register its notice of proposed rule-making regarding Providers obligations to report and return Medicaid overpayments to comply with Section 6402 of the Patient Protection and Affordable Care Act (P.L. 111-148). Under the proposed rule, providers, including managed care organization’s contracted providers, are obligated to self-report overpayments within sixty (60) calendar days after such provider has identified (or been notified) of the overpayment. HSD intends to comply with this proposed rule. For more information you may review the proposed rule at 77 Fed. Reg. 9179 et seq.
ICD10 Implementation Update
Molina Healthcare has fully implemented ICD-10. Have questions? Looking for additional information?Learn more.
LTSS Quick Reference Guide
Looking for information about requesting authorization or submitting a claim for Long-Term Services and Supports? Learn more.