Provider Bulletin

The Provider Bulletin is published for Molina Healthcare participating providers in Ohio to communicate updates about medical management policies and procedures.

Sign up to receive Molina Healthcare's Provider Bulletin via email here. 

*The links below are in PDF format (pdf icon)

2025  Month 
Provider Bulletin: Changes to the Provider Manual, Q3 PA Code Changes, Availity Essentials Updates: PA, Claim Disputes and Digital Correspondence, Nursing Facility and Hospice Ventilator and Ventilator Weaning, Alzheimer's Disease and Related Demential Program, Recorded Trainings on Provider Website, ODM MyCare Ohio Program Launch, Quality Living Program Awardees, UPDL: 30-Day Change Notice, EVV Claim Processing Changes, Molina Clinical Policy Page Updates, You Matter to Molina: Get to Know Your Provider Relations Representatives, Website Roundup, Live Provider Training Sessions  June 2025 
Quality Provider Bulletin: Healthy Children: Well-Care Visits, Healthy Adults: Annual Wellness Visit, Women's Health: Breast and Cervical Cancer Screenings, Chronic Conditions: Hypertension, Behavioral Health, Older Adults: Continuous Glucose Monitoring May 2025
Provider Bulletin: EVV Claim Processing Changes, Molina Clinical Policy Page Updates, Explanation of Payment Update, Drugs Carved Out: Fee-for-Service, You Matter to Molina: Structured Family Caregivers Orientation, Ownership & Control Disclosure Form Requirements, Molina Check Runs, You Matter to Molina: Get to Know Your Provider Relations Representatives, Live Provider Training Sessions  May 2025
Provider Bulletin: Provider Office Lab Testing Policy, MCO Resource Document for Doulas, 2025 HEDIS® Data Collection, PNM Update: Multi-Factor Authentication, You Matter to Molina: Disability Awareness and Sensitivity Training, Americans with Disabilities Act, Provider Demographic Information: Fax Number for Dispute Resolution, Emailing Protected Health Information (PHI) Securely, Q1 Provider Newsletter, Updated: You Matter to Molina: Get to Know Your Provider Relations Representatives, Updated: Live Provider Training Sessions April 2025
Provider Bulletin - Special Edition: Annual Mandatory D-SNP Medicare Model of Care Training March 2025
Provider Bulletin - Special Edition: Evolent Cardiology Policies Update March 2025
Quality Provider Bulletin: Removal of Telehealth from W30 and WCV HEDIS® Measures, Yearly Adult Preventative Care Visits, Chlamydia Screening, New HEDIS® Measure - Blood Pressure Control for Patients with Hypertension (BPC-E), Breast Cancer Screening for Older Adults March 2025
Provider Bulletin: Special Experience Survey, All MCO Semi-Annual Meeting for CPC and CMC Practices, Medicaid Timely Filing Extension Ending, Overpayment Policy Update, ODM EVV Implementation Updates, Nursing Facility Ventilator Pre-Payment Policy, Q2 PA Code Changes, UPDL: 30-Day Change Notice, Availity Essentials Portal Reconsiderations vs. Appeal Options Update, Temporary Waiver of PA Requirements for Nursing Facility Admissions, Recorded Trainings, Dental Claim and Authorization Inquiries, Real-Time Claim Adjustments, You Matter to Molina: Get to Know Your Provider Relations Representatives, Annual Mandatory Model of Care Training, Live Provider Training Sessions  March 2025 
Provider Bulletin - Special Edition: Temporary Waiver of PA Requirements for Nursing Facility Admissions  February 2025 
Provider Bulletin - Special Edition: Annual Mandatory Model of Care Training  February 2025 
Provider Bulletin: Hospice Billing for Nursing Facility Room and Board, Annual Mandatory D-SNP Medicare Model of Care Training, You Matter to Molina: Get to Know Your Provider Relations Representatives, Live Provider Training Sessions, Quality Living Program Awardees, In Case You Missed It February 2025
Provider Bulletin - Special Edition: Annual Mandatory D-SNP Medicare Model of Care Training January 2025
Provider Bulletin - Special Edition: Evolent Health: Unblocking Molina Fax Numbers for Utilization Management Communication  January 2025 
Provider Bulletin: Inpatient Admission Notification Process Reminder, NF Private Room Billing Guidance, Access2Care Email Address Update, YMTM: Get to Know Your Provider Relations Rep., UPDL: 30-Day Change Notice, Drugs Carved Out: FFS, Q4 Provider Newsletter, ODM Coverage: COVID-19 At-Home Test, Live Provider Training Sessions, Availity Authorizations Update Reminder, Notice of Changes to the Provider Manual  January 2025 
2024 Month
Provider Bulletin: Model of Care Training, Availity Auth Update, Provider Authorization Appeal Extension of Timeframe, Inpatient Admission Notification Change, Notice of Changes to the Provider Manual, Q1 2025 PA Code Changes, New Molina CES Edit 9523, Provider Relations Contact Page, NDC Denials Reminder, Website Roundup, Hospice Room and Board Payments, Ohio Recovery Housing Residences Registration, Quality Living Program Awardees, ODM Designated Provider and Non-Contracted Provider Guidelines, Diabetes Benefits Update in 2024, Live Provider Training Sessions  December 2024 
Provider Bulletin: Availity Auth Update, Model of Care Training, CES Edit 9164, OAC 5160-44-05 Update, Procedure Codes T2042-T2045 Update, ODM BH Provider Manual, Claim Reconsideration Process, Corrected Claim Process, How to Compress Files, Live Provider Training Sessions November 2024
Quality Provider Bulletin: Access to Care, Telehealth, Doulas, and Molina Benefits for Pregnant People, Chronic Conditions, Healthy Adults, Healthy Children, Behavioral Health November 2024
Provider Bulletin - Special Edition: Evolent Health: Oncology Update November 2024
Provider Bulletin - Special Edition: Availity Authorizations Update, Advanced Imaging PA Submission Change October 2024
Provider Bulletin: Availity Essentials Portal Reconsiderations vs. Appeal Options, Open Enrollment: January 2025, Behavioral Health Peer Support Service, Structured Family Caregiving Waiver Rates, 2024/2025 Flu Season Recommendations, Live Provider Training Sessions, New Diabetes Care Hub, Q3 Provider Newsletter, Access Standards, Americans with Disabilities Act, Doula Services October 2024
Provider Bulletin: Medicaid Timely Filing Extension, Q4 PA Code Changes, New Molina Cotiviti Edits, New Medicare Benefit, CPT II Coding Training, Doula Services, Optum Prepayment Claim Review, UPDL: 30-Day Change Notice, Diabetes Benefits Update in 2024, Live Provider Training Sessions, EVV: Claims Adjudication Process September 2024 
Provider Bulletin: PNM: Inactive Status, Advanced Imaging PA Submission Change, Optum Prepayment Claim Review, EVV: Claims Adjudication, Remind Patients: Healthchek, Quality Living Program Awardees, Molina Expands Partnership: Evolent Health, Live Provider Training Sessions, Q3 PA Code Changes for Oncology August 2024
Quality Provider Bulletin: Follow-up Care and Readmission Reductions, Glycemic Status Assessment for Patients with Diabetes (GSD), Healthy Children and Adults, Molina Incentivizes Healthy Behaviors
 August 2024
Provider Bulletin - Special Edition: Updated Launch Date: Expanded Partnership with Evolent Health July 2024
Provider Bulletin: Molina Expands Partnership with Evolent Health, Live Provider Training Sessions, ODM Provider Appointment Access and Availability Surveys, Observation Status, HCBS Waiver: Assisted Living Update, Professional Claims Limit of 50, EVV: Live-In Caregivers, EVV: GPS Consent Form, EVV: Training, Itemized Statement Requirements, Provider Hours Requirement, Dental Reminder, Q2 Provider Newsletter, Q3 PA Code Changes for Oncology July 2024
Provider Bulletin: Live Provider Training Sessions, Q3 PA Code Changes, Notice of Changes to Provider Manual, UPDL: 30-Day Change Notice, Availity Essentials Portal: HEDIS Profile, Molina Provider Surveys, Balance Billing, OhioRISE Mixed Services Protocol, LGBTQ+ Covered Services, Molina Expands Partnership with Evolent Health, Website Roundup, Diabetes Benefits Update in 2024, Hospice and Vent/Vent Weaning Billing Guidelines, In Case You Missed It June 2024
Quality Provider Bulletin: Diabetes Self-Management Education, Provider Messaging Most Powerful for Patients, Child and Adolescent Well Visits, Annual Adult Visits, Antidepressant Medication Management, Disparities and Health Equity in LGBTQ+ Seniors May 2024
Provider Bulletin: Live Provider Training Sessions, ODM Update: Terminations Resuming for Failure to Complete Medicaid Agreement Revalidations in PNM, Reimbursement Policy: DME Rental vs. Purchase, Home Health Authorization Requests for Special and Complex Needs, MCOs Reinvest in Ohio Communities, Drugs Carved Out: Fee-for-Service, Requests for Retrospective Authorization, Quality Living Program Awardees, PA Requirements: Non-Par Providers, Ownership and Control Disclosure Form Requirements, Molina of Ohio Check Runs, Review Phone Numbers in the PNM, Website Roundup, CMS Final Rule for CY24: BH Changes, In Case You Missed It May 2024
Provider Bulletin - Special Edition: Update April 5, 2024: Optum-Change Healthcare Outage
 April 2024
Provider Bulletin - Special Edition: Annual Mandatory D-SNP Medicare Model of Care Training
 April 2024
Provider Bulletin: New Provider Bulletin Layout, New Molina CES Edit 9162 Not a Principal Diagnosis Code, Cost of Poverty Experience (COPE) Simulation, Annual Mandatory Model of Care Training, Q1 Provider Newsletter, Provider Training Sessions, In Case You Missed It
 April 2024
Provider Bulletin - Special Edition: Update March 18, 2024: Optum-Change Healthcare Outage
 March 2024
Provider Bulletin - Special Edition: Update: Optum-Change Healthcare Outage March 2024
Provider Bulletin: Provider Bulletin Survey, Q2 PA Code Changes, Optum-Change Healthcare, 2024 HEDIS, TenderHeart Health Outcomes, Annual Wellness Visits, Acupuncture Services, How to Understand Advances, UPDL: 30-Day Change Notice, Website Roundup, Did You Know: Help Finder, Emailing PHI Securely, Americans with Disabilities Act, Demographic Info: Fax Number, CMS: Appt Times & Specialties, Provider Training Sessions, Provider Manual Update, ODM Update, Post-Stabilization, You Matter to Molina, Cotiviti Drug & Biological Edits, Coordinated Services Program, CMS: BH Changes, Medicaid Renewals, CES Edit 9531, MCG Auto-Auth Adv. Imaging, Hemgenix & Roctavian, Diabetes Benefit Updates, PA Request Forms Reminder, Enrollment Requirements, Availity Appeals Submission March 2024 
Provider Bulletin - Special Edition: Update: Optum-Change Healthcare Outage February 2024
Provider Bulletin - Special Edition: Optum-Change Healthcare Outage February 2024
Quality Provider Bulletin: Voice of the Customer, Controlling Blood Pressure, The Great Paradigm Shift, Older Adults are Embracing Technology February 2024
Provider Bulletin: ODM Update: Terminations to Resume for Failure to Complete Medicaid Agreement Revalidations in PNM, Post-Stabilization, You Matter to Molina, New Molina Cotiviti Drug and Biological Edits, New Molina CES Edit 9531 Inappropriate Modifier to Diagnosis Combination, Molina Policy COVID-19 Bypasses, Provider Training Sessions, OhioRISE Mixed Services Protocol Updated, Prior Authorization (PA) Code Update: 0345U, Hemgenix and Roctavian Coverage, Reimplementation of the Coordinated Services Program, CMS Final Rule for CY24: Appointment Wait Time Standards and List of Evaluated Specialties Update, MCG Auto-Authorization Advanced Imaging, PsychHub Information, CMS Final Rule for CY24: BH Changes, Quality Living Program Awardees, Updated: Notice of Changes to the Provider Manuals, ePRAF: Technical Assistance Intervention Package, Updated: New ODM BH Provider Manual and Rates, Dental Credentialing Update, ePRAF: Quality Enhancer Incentive Program, Claim Hold on Marketplace PPS, Diabetes Benefits Update in 2024, Process for Submitting EDI Inquiries to Molina, Third Party Liability Exception, Real-Time Claim Adjustments, PA Request Forms, Medicaid Enrollment Requirements, Claim Status Secure Messaging: Availity, Medicaid Renewals, New Availity Function: Submit and Track Appeals, EOP Refund and Forwarding Balance Enhancement February 2024
Provider Bulletin – Special Edition: Significant Updates for 2024 Medicaid Provider Manual January 2024
Provider Bulletin: Updated: Molina Policy COVID -19 Bypasses, PA Code Update: 0345U, New Functionality in Availity: Submit and Track Appeals, Reimplementation of the Coordinated Services Program, Provider Training Sessions, Ohio Recovery Housing Residences Registration, OhioRISE Mixed Services Protocol Updated, Claim Hold on Marketplace Prospective Payment System, Updated: Notice of Changes to the Provider Manuals, Medicaid Renewals, New ODM Behavioral Health Provider Manual and Rates, Q4 Provider Newsletter, PA Request Forms Reminder, Evaluation and Management (E&M) Reminder, CMS Final Rule for CY24: Appointment Wait Time Standards and Additional Professionals Included on the List of Evaluated Specialties, CMS Final Rule for CY24: Behavioral Health Changes, Update: New Century is Now Evolent, ODM Source of Truth for Provider Data, Review Your Molina Medicaid Member's Renewal Date in Availity, ODM Rate Updates for 2024, New Medicare PA Guide, Forms, Diabetes Benefits Update in 2024, Medicaid Enrollment Requirements, ePRAF: Technical Assistance Intervention Package, EOP Refund and Forwarding Balance Reporting Enhancement, ePRAF: Quality Enhancer Incentive Program, HEDIS Measure: Transitions of Care, Molina CES Edit 9534 – Modifier GZ, New Molina CES Edit 9056 – Unspecified Code, Retirement of Episode-Based Payment Model Reports, Optum Prepayment Claim Audit, Claim Status Secure Messaging: Availity Essentials Portal, Dental Credentialing Update January 2024
2023 Month
Provider Bulletin - Special Edition: Significant Updates for 2024 MyCare Ohio Provider Manual  December 2023 
Provider Bulletin: PA Code List Update, Retirement: Episodes of Care, New Name: Provider Relations, CES Edit 9056, CES Edit 9534, Prepayment Claim Audit, HEDIS: Transitions of Care, Real-Time Claim Adjustments, Secure Message: Claim Status, Non-Contract Provider Guide, Dental Credentialing Update, UPDL: 30-Day Change Notice, Website Roundup, New Century is Now Evolent, Medicare PA Guide and Forms, Provider Training Sessions, Changes to Provider Manual, EOP Refund, Annual Model of Care, Source of Truth, TenderHeart Health Outcomes, Respiratory Syncytial Virus, Electronic Visit Verification, 2023/2024 Open Enrollment, Enrollment Requirements December 2023 
Quality Provider Bulletin: Breast and Cervical Cancer Screenings - Member Incentives, Improving Follow-up After Hospitalization for Mental Illness (FUH) Rates, Childhood Immunizations, Schedule and Complete Adult Annual Visits Before End of Year, Diabetes Self-Management Education, Diabetes Care November 2023
Provider Bulletin: ODM Source of Truth for Provider Data, Respiratory Syncytial Virus Season, Electronic Visit Verification (EVV), Molina Quality Living Program Awardees, Provider Training Sessions, How to Compress Files, 2023/2024 Open Enrollment, Claim Hold on Marketplace Prospective Payment System, Medicaid Enrollment Requirements, MCG Auto-Authorization Advanced Imaging: Cite AutoAuth, Review You Molina Medicaid Member's Renewal Date in Availity, TenderHeart Health Outcomes Partnership, Marketplace Skilled Nursing Facility Per Diem, Annual Mandatory Model of Care Training, Access Standards, Corrected Claims Process, Notice of Changes to PA Requirements, Claims Reconsideration Process, Notice of Changes to the Provider Manual, Fighting Fraud, Waste and Abuse November 2023
Provider Bulletin - Special Edition: Provider Network Management (PNM) Source of Truth October 2023
Provider Bulletin: Hospice & Vent/Vent Weaning, 2023/2024 Open Enrollment, Marketplace Claim Hold, 2023/2024 Flu Season, CES Edit 9531, Prepayment Claim Audit, E&M Update, Dexcom Web Series: CGMs, Q3 Provider Newsletter, Molina COVID-19 Bypasses, MCG Auto-Auth Adv. Imaging, Provider Training Sessions, Prepayment Coding Validation, TenderHeart Health Outcomes, Value-Added Benefits, ORP Provider Information, Annual Model of Care, It Matters to Molina Corner, Enrollment Requirements, Renewal Date in Availity, EOP Refund Enhancements, Marketplace SNF Per Diem, Changes to PA Code List, Changes to Provider Manual October 2023 
Provider Bulletin: Molina Policy COVID-19 Bypasses, MCG Auto-Auth Adv. Imaging, New Prepayment Coding Validation, ORP Provider Information, CES Edit 9031 Add-On Procedure, CES Edit 9056 Unspecified Diagnosis, CES Edit 9064 Modifier 78, CES Edit 9130 Home Health Code 50, CES Edit 9523 Surgical Procedure, Provider Hours Requirement, Americans with Disabilities Act, Remind Patients about Healthchek, UPDL: 30-Day Change Notice, Changes to PA Code List, TenderHeart Health Outcomes, Provider Training Sessions, Value-Added Benefits, Marketplace SNF Per Diem, Member Renewal Date in Availity, It Matters to Molina Corner, Medicaid Enrollment Requirements, EOP Refund Enhancements, CMC MCO Resource Guide, Annual Model of Care, Changes to Provider Manual  September 2023 
Provider Quality Bulletin: Back-to-School and Well-Care Visits, Annual Adult Visits, Cervical Cancer Screenings with a Look into Health Equity, Continuous Glucose Monitors, Antipsychotic Metabolic Monitoring, Older Adults August 2023
Provider Bulletin: "It Matters to Molina" Corner, Value-Added Benefits, Application of Modifier 78, New Cotiviti Edit for Lipid Testing, EOP and 835 Files Refund Reporting Enhancement, Cost of Poverty Experience (COPE) Simulation, Balance Billing, Marketplace Skilled Nursing Facility Per Diem, Annual Mandatory Model of Care Training, Ohio CMC MCO Consolidated Resource Guide, Molina Quality Living Program Awardees, Process for Submitting EDI Inquiries to Molina, Members' Obstetric and Gynecological Health Reminder, TenderHeart Health Outcomes Partnership, Annual Mandatory Model of Care Training, Quest Diagnostics: Molina's Preferred In-Network Clinical Laboratory Provider, Molina Credentialing Update, PsychHub Information on Provider Website, Behavioral Health QMHS Billing Modifier, Review Your Molina Medicaid Member's Renewal Date in Availity, Notice of Changes to PA Requirements, Fighting Fraud, Waste, and Abuse, Notice of Changes to the Provider Manual August 2023
Provider Bulletin: Quest Diagnostics: Molina's Preferred In-Network Clinical Laboratory Provider, Annual Mandatory Model of Care Training, Modifier Utilization for Facility Claims, Molina Hospice and Vent/Vent Weaning Billing Guidelines, Itemized Statement Requirements, Ohio CMC MCO Consolidated Resource Guide, Q2 Provider Newsletter, National Provider Identifier (NPI) and Claim Submission, Ohio Amblyope Registry, Process for Submitting EDI Inquiries to Molina, Behavioral Health QMHS Billing Modifier, Medicaid Enrollment Requirements, TenderHeart Health Outcomes Partnership, Molina Credentialing Update, Non-Emergency Medical Transportation, Review Your Molina Medicaid Member's Renewal Date in Availity, Enteral Nutrition Payment Changes, Notice of Changes to PA Requirements, Notice of Changes to Provider Manual, Fighting Fraud, Waste, and Abuse July 2023
Provider Bulletin - Special Edition: Ownership and Control Disclosure Form Requirement
 June 2023
Provider Bulletin: Process for Submitting EDI Enquiries to Molina, TenderHeart Health Outcomes Partnership, Notice of Changes to PA Requirements, Notice of Changes to the Provider Manual, Non-Emergency Medical Transportation, Add-On Procedure Codes, Psychiatric Diagnostic Evaluation Limitations, Member Renewal Date in Availity, Did You Know: Pacify, Molina Credentialing Update, Enteral Nutrition Payment Changes, FDA Withdrawal of Makena®, Nursing Coverage to Meet Personal Care Needs, Fax Submission File Size Update for Clinical Information, Ohio Pulsewrx Program for Continuous Glucose Monitoring, End of COVID-19 PHE: PASRR, A&G Mailing Address Update, Unified Preferred Drug List: 30-Day Change Notice, Molina Quality Living Program Awardees, Revenue Code 0120 Update, Reimplementation of PAs for Specific Drug Classes, Filing Expedited Service Requests or Appeals, EOP and 835 Files Refund Reporting Enhancement, Medicaid Enrollment Requirements, Women, Infants and Children (WIC),  Ordering, Referring, and Prescribing Providers NPI, Molina Legacy Provider Portal Sunsetting, New Century Health Fax Number Update, Partnership with Avalon for Laboratory Benefit Management June 2023
Provider Bulletin - Special Edition: Molina Legacy Provider Portal Sunsetting, Important Information Regarding the Resumption of Medicaid Renewals, Provider Demographic Updates, Get the Molina Provider Bulletins via Email
 May 2023
Provider Bulletin - Special Edition: Annual Mandatory D-SNP Medicare Model of Care Training
 May 2023
Provider Bulletin - Special Edition: End of COVID-19 Public Health Emergency (PHE) May 2023
Provider Quality Bulletin: Electronic Prenatal Risk Assessment Form (ePRAF) and Progesterone Changes, Preventive and Sick Visits on the Same Date of Service, Tips to Improve Adult Preventive Care Visits, Health Equity and Disparities in Older Adults, Diabetes Self-Management Education May 2023
Provider Bulletin: Enteral Nutrition Payment Changes, Medicaid Alert Regarding Fraud Attempts, Behavioral Health Toolkit, Surgical Procedure Anatomical Modifier, PAs for Specific Drug Classes, COVID-19 (Coronavirus) Codes, Molina EMR Messaging, FDA Withdrawal of Makena®, Molina Legacy Provider Portal Sunsetting, Fax Submission File Size Update, New Services Added to Prepayment Coding Validation, ABN Guidance, Guided Care Rebranding, New Century Health Fax Number Update, Appeals and Grievances (A&G) Mailing Address Update, Revenue Code 0120 Update, Filing Expedited Service Requests or Appeals, EOP and 835 Files Refund Reporting Enhancement, Resumption of Medicaid Renewals, Partnership with Avalon for Laboratory Benefit Management, Medicaid Enrollment Requirements, Women, Infants, and Children (WIC), Ordering, Referring, and Prescribing Providers NPI, It Matters to Molina Corner, Availity Overpayments, Changes to PA Requirements, Fighting Fraud, Waste, and Abuse, Changes to Provider Manual May 2023
Provider Bulletin - Special Edition: FDA Withdrawal of Makena® April 2023 
Provider Bulletin - Special Edition: Molina Legacy Portal Sunsetting, New Enhancements in Availity, Availity Provider Portal Training, Medicaid Renewals, Provider Demographic Updates, Get the Molina PB via Email  April 2023 
Provider Bulletin: Fax Submission File Size, ABN Guidance, Molina Guided Care Rebranding, EOP and 835 Enhancements, Prepayment Coding Validation, New Century Health Fax Number, A&G Mailing Address Update, Filing Expedited UM Requests, Revenue Code 0120 Update, Payer ID Reminder, Medicaid Enrollment Requirements, Did You Know: Molina Help Finder, BH QMHS Billing Modifier, Women, Infants, and Children (WIC), Molina of Ohio Check Runs, Q1 Provider Newsletter, Medicaid Renewals, Partnership Avalon Healthcare, Molina Legacy Portal Sunsetting, ORP Providers NPI, It Matters to Molina Corner, Provider Training Sessions, Changes to PA Code List, Website Roundup, BH Codes: H2020, H0038, H0048, Demographic Info: Fax Number, Availity: Overpayments Process, 2023 HEDIS Data Collection, Care Coordination Portal, Medicare PA Guide and PA Forms, New Century/ProgenyHealth, Changes to Provider Manual  April 2023 
Provider Quality Bulletin: Child Dental and Well-Care Visits, Adult Access to Preventive Health Services, Mid-Ohio Farmacy Program, Medicaid Renewal Information, PRAF vs. ROP, Follow-up After Hospitalization for Mental Illness HEDIS Measurement Information March 2023

Provider Bulletin: Next Gen Medicaid Program, Important Information Regarding the Resumption of Medicaid Renewals, Ordering, Referring, and Prescribing Providers NPI, Changes to PA Requirements, Provider Demographic Information: Fax Number for Dispute Resolution, Availity: Overpayments Process, 2023 HEDIS Data Collection, Molina Quality Living Program Awardees, Behavioral Health Codes: H2020, H0038, and H0048, Molina Legacy Provider Portal Sunsetting, Partnership with Avalon for Laboratory Benefit Management, It Matters to Molina Corner, You Matter to Molina: Video Series for Members, Provider Training Sessions, Weight Watchers, UPDL 30 Day Change Notice, Emailing PHI Securely, Americans with Disabilities Act, Care Coordination Portal, Molina of Ohio Clinical Policies, Medicare PA Guide and PA Forms, Authorization Appeal New Century Health or ProgenyHealth, PASRR Process for Nursing Facilities, Changes to the Provider Manual

 March 2023
Provider Bulletin - Special Edition: Next Generation Medicaid Program 2/1 Go Live, Medicaid Paper Claims, Provider Access to the Molina Care Coordination Portal through Availity Essentials Portal, New Provider Claim Disputes Process, Provider Network Management Module and MITS Maintenance Downtime February 2023
Provider Bulletin: Changes to Provider Manuals, Molina of Ohio Clinical Policies, Marketplace Hospice Claims, Care Coordination Portal, PASRR Process for Nursing Facilities, Reminder: Rendering Provider on Professional Claims Submissions, Partnership with Avalon for Laboratory Benefit Management, Claims Hold on Prospective Payment System, Auth Reconsiderations New Century Health or ProgenyHealth, Next Gen Medicaid Dec 1 Launch Delay, Molina Legacy Provider Portal SunSetting, "It Matters to Molina" Corner, You Matter to Molina: Online Resources, Next Gen Ohio Medicaid Feb 1 Launch Resources, Fighting Fraud, Waste and Abuse, Provider Training Sessions, Website Roundup, Medicare PA Guide and PA Forms, ProviderNet SunSetting, Columbus Measles Outbreak, PsychHub Information, Drugs Carved Out: Fee-for-service, Explanation of Payment Refund Reporting, Provider Contract for Next Gen Medicaid, Notice of Changes to PA Requirements February 2023
Provider Bulletin: New Claim Disputes Process, Dec 1 Deadline for Annual MOC Training, Rendering Provider Claim Submissions, Partnership with Avalon Healthcare for Laboratory Benefit Management, Claims Hold on Prospective Payment system, Authorization Reconsiderations New Century Health or ProgenyHealth, Drugs Carved Out: Fee-for-Service, Columbus Measles Outbreak, BH: Other Licensed Professionals, Next Gen Medicaid December 1 Launch Delay, ProviderNet Sunsetting, Molina Legacy Provider Portal Sunsetting, Claim Submission: Electronic and Paper, It Matters to Molina Corner, You Matter to Molina: Provider Contracting Team, Next Gen Program Feb 1 Launch Resources, 2022-2023 Open Enrollment, Provider Training Sessions, MCG Auto-Authorization, Behavioral Health Provider Manual, Oxygen Rental Only Codes, Q4 Provider Newsletter, PsychHub Information on Provider Website, COVID-19 (Coronavirus) Codes, Molina Help Finder, Explanation of Payment Refund Reporting, Provider Contract for Next Gen, Tips for Preparing Patients for Telehealth Visits, Changes to PA Requirements, Changes to the Provider Manual, Next Gen Medicaid: PNM, SPBM, and OH|ID January 2023 
2022 Month
Provider Bulletin - Special Edition: Q1 2023 PA Code List Update  December 2022 
Provider Bulletin: Next Gen Medicaid December 1 Launch Delay, Updated: Changes to PA Requirements, Updated: Changes to the Combined Provider Manual, Molina Legacy Provider Portal Sunsetting, ProviderNet Sunsetting, Explanation of Payment Refunding Reporting, Healthmap Solutions, Molina Help Finder, Reminder: Claim Submission: Electronic and Paper, It Matters to Molina Corner, Reminder: Next Gen Medicaid: PNM, SPBM, and OH|ID, Unified Preferred Drug List: 30-Day Change Notice, Provider Payment and Bank Information, Annual Mandatory Model of Care Training, Updated: 2022-2023 Open Enrollment, Provider Training Sessions, Updated: COVID-19 Codes, PNM Requirement for EVV System, EVV Training, Claim Reconsideration Status Now Live on the Availity Portal, Provider Contract for Next Gen Medicaid, Tips for Preparing Patients for Telehealth Visits, PsychHub Information on Provider Website December 2022 
Provider Quality Bulletin: Mid-Ohio Farmacy Program, Annual Dental and Well-Care Visits, Important Facts about the Prenatal Risk Assessment Form (PRAF), Improved Access to Mental Health Care Through OhioRISE, Pre-paid DSME Slots, Community-Based Organization (CBO) Collaboration December 2022 
Provider Bulletin: Next Generation Medicaid: PNM, SPBM, and OH|ID, 2022/2023 Flu Season Recommendations, Tips for Preparing Patients for Telehealth Visits, Claim Submission: Electronic and Paper, EVV Training, EVV Visit Updates, Evaluation and Management Services Billed with Rev. Code 0761, Shortened Benefit Year: Next Gen Medicaid Program, BH Provider Manual, PsychHub Information on Provider Website, ODM BH Limits, Audits, and Edits, Psychological and Neuropsych Testing PA Code List, BH Code Edit Requirements, Updated: COVID-19 Codes, Updated: Claims Processing Update: Modifiers, It Matters to Molina Corner, You Matter to Molina: Get to Know Your Provider Representatives, 2022-2023 Open Enrollment, Provider Training Sessions, Changes to PA Requirements, Changes to the Provider Manual, How to Compress Files, Access Standards, Corrected Claims Process, Claim Reconsideration Process, Updated: OhioRISE Information, Claim Reconsideration Status Now Live on the Availity Portal, Reminder: Sterilization, Hysterectomy, and Abortion Consent Forms, Reminder: Maternal and Infant Support Program (MISP), SUD Residential Treatment Notification of Admission Form, Provider Contract for Next Gen Medicaid, Annual Mandatory Model of Care Training, Health Care Education: Outcomes for People with Disabilities November 2022 
Provider Bulletin: Changes to the Provider Manual, Do You Have Your OH ID, PNM and OH ID Top 5 Things You Need to Know, Next Gen Medicaid Program Updates and Trainings, Maternal and Infant Support Program (MISP), Claims Processing Update: Modifiers, Paper Claim Submission, Sterilization, Hysterectomy, and Abortion Consent Forms, It Matters to Molina Corner, You Matter to Molina: Get to Know Your Provider Representatives, Molina Quality Living Program Awardees, Updated Monkeypox Vaccine Codes, Screening Mammography Update, Change Healthcare Settlement Advocate Migration with ECHO Health Inc., Provider Training Sessions, Changes to PA Requirements, Respiratory Syncytial Virus Season, Claim Reconsideration Status Live on Availity Portal, Chiropractic Services Benefit Year, MCG Auto-Authorization, Americans with Disabilities Act, Q3 Provider Newsletter, American Academy of Pediatrics Foundation Luncheon, OhioRISE Information, SUD Residential Treatment Notification of Admission Form, LTSS Respite Services for Children, Provider Contract for Next Gen Medicaid, Annual Mandatory Model of Care Training, Health Care Education: Improved Outcomes for People with Disabilities October 2022 
Provider Quality Bulletin: Completed PRAF is a Win-Win for the Provider and Member, Annual Dental and Well-Care Visits for School-Age Children Initiative, All-MCP Improvement Initiative: DSME and CGM Intervention Testing September 2022 
Provider Bulletin – Special Edition: Change Healthcare and ECHO Health update  September 2022 
Provider Bulletin – PNM and OH|ID: Top 5 Things, Next Gen Updates and Training, Monkeypox Vaccine Codes, Value Code 80, 81, and 74, Screening Mammography Update, Molina Clinical Policies, UPDL: 30-Day Change Notice, Molina Prepayment Claim Reviews, Update: Change Healthcare, SUD Residential Treatment Form, Changes to PA Code List, OhioRISE Information, Updated: COVID-19 Codes, It Matters to Molina Corner, You Matter to Molina: PS Reps, Provider Training Sessions, Website Roundup, MCG Auto-Authorization, Changes to Provider Manual, LTSS Respite Services for Children, Provider Contract Next Generation, External Wheelchair Assessment, Genetic Testing Update, Readmission Payment Policies, Institution for Mental Disease Stays, Annual Model of Care, Medicare PA Guide and Form, Health Care Education, Clinical Services – Adv. Imaging, DSME for Medicaid September 2022 
Provider Bulletin – Special Edition: OhioRISE Implementation August 2022 
Provider Bulletin – Special Edition: Change Healthcare and ECHO Health August 2022 
Provider Bulletin – Special Edition: Update: Change Healthcare Outage August 2022 
Provider Bulletin – OhioRISE Information, Upcoming MITS Freeze, Molina Provider Bulletin Update, Requirements for Type of Bills, Provider Hours Requirement, External Wheelchair Assessment, Sandata EVV Member Validation, LTSS Respite Services for Children, Quality Living Program Awardees, Marketplace Notice of Reg. Updates, Website Roundup, Genetic Testing Update, Updated: COVID-19 Codes, It Matters to Molina Corner, You Matter to Molina: PS Reps, Provider Training Sessions, Changes to Provider Manual, Clinical Services – Adv. Imaging, Changes to PA Code List, Provider Contract Next Generation, Readmission Payment Policies, Institution for Mental Disease Stays, Roster: Affiliations with Practitioners, MCG Auto-Authorization, Annual Model of Care, Home Health Prior Authorization, Medicare PA Guide and Form, Health Care Education, DSME for Medicaid  August 2022
Provider Bulletin – Special Edition: Change Healthcare ProviderNet July 2022 
Provider Bulletin – Special Edition: Next Generation Stage 2 Training July 2022 
Provider Bulletin – It Matters to Molina Corner, Update Affiliations with Practitioners, Clinical Services – Adv. Imaging, Medicare PA Guide and Form, Readmission Payment Policies, Institution for Mental Disease Stays, Balance Billing, Itemized Statement Requirements, COVID-19 New Code, Updated: MCG Auto-Authorization, DSME for Medicaid, Partial Hospital & SUD Update, Home Health Prior Authorization, Expansion of Telehealth Services, You Matter to Molina: PS Reps, Immunizations Temporary Policy, Provider Training Sessions, Changes to Provider Manual, Changes to PA Code List, Next Generation Medicaid Update, UPDL: 30-Day Change Notice, Provider Contract Next Generation, Annual Model of Care, Q2 Provider Newsletter, Remind Patients about Healthchek, Psychological/Neuropsych Testing, PsychHub Information, Chiropractic Services Expansion, Member Contact Information, Health Care Education, Sequestration Reduction  July 2022 
Provider Bulletin – Special Edition Behavioral Health: Ohio CANS Information Technology System, Update on Coordination of Benefits, Reminder for BH Billing Agencies to Update Affiliations with their Practitioners, Notice of Changes to Prior Authorization Requirements, Prolonged Service Codes: 99354 and 99355, Ordering, Referring, and Prescribing Providers NPI, BH Centralized Fax Numbers, Claim Reconsiderations, SUD Services PA Request Form, Billing Code Added for Pregnancy Report, PsychHub on the Molina Provider Website, BH Provider Manual, Provider Enrollment in MITS, Changing a Remittance Address, Changing a Service Location Address, Non-Contracted BH Providers, Update to Definitive UDS Counts, BH Cash Advance Repayments, BH Limits, Audits, and Edits June 2022 
Provider Bulletin - Special Edition: Next Generation Medicaid Program: OhioRISE Implementation Quick Reference Guide June 2022 
Provider Quality Bulletin: Diabetes Quality Improvement Collaborative Projects CGM and DSME, Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) Initiative, COVID-19 Vaccinations June 2022 
Provider Bulletin - Special Edition: Model of Care Training  June 2022 
Provider Bulletin - Special Edition: FQHC & RHC Coverage, Q3 PA Code List Update, Provider Training Opportunities  June 2022 
Provider Bulletin - It Matters to Molina Corner, Changes to PA Code List, Psychological/Neuropsych Testing, UPDL: 30-Day Change Notice, OhioRISE Fundamentals Webinar, Next Generation Medicaid Update, Coverage Changes FQHC & RHC, Partial Hospital & SUD Update, Home Health Prior Authorization, HCIC Notice of Program End Date, Counseling Codes 99401 & 99402, Reminder: BH Code Edits, PsychHub Information, Chiropractic Services Expansion, Expansion of Telehealth Services, You Matter to Molina: PS Reps, Provider Training Sessions, Changes to Provider Manual, Website Roundup, Provider Contract Next Generation, Member Contact Information, New Century Health, Updated: MCG Auto-Authorization, Availity Info on Provider Website, Maternal and Infant Support, Health Care Education, Sequestration Reduction  June 2022 
Provider Bulletin - It Matters to Molina Corner, Next Generation Medicaid Update, Maternal and Infant Support, COVID-19 Vaccine Counseling, COVID-19 Vaccination Booster, Consent Form Requirements, Coverage of Apo-Varenicline, New Century Health, ODM Training Opportunities, You Matter to Molina: PS Reps, Updated: MCG Auto-Authorization, Medicaid ID for EVV, Provider Training Sessions, Changes to Provider Manual, Changes to PA Code List, Website Roundup, Provider Contract Next Generation, Availity Info on Provider Website, Medicare Home Health PA Fax, Health Care Education, Sequestration Reduction, COVID-19 Test Kits   May 2022
Provider Bulletin - Special Edition: ARPA COVID-19 Provider Relief Funds  April 2022 
Provider Bulletin - Special Edition: Post-Acute Authorization Requirements Update   April 2022 
Provider Bulletin - Special Edition: Home Health PA Fax Number and EVV Webinar  April 2022 
Provider Bulletin: It Matters to Molina Corner, Changes to the Provider Manual, Unified Preferred Drug List 30 Day Change Notice, Coverage of Apo-Varenicline, New Century Health, Clinical Policy Website, OhioRISE Training Opportunities, You Matter to Molina: Get to Know Your Provider Representatives, Revenue Codes Billing Update, Availity Information on Provider Website, Medicaid ID Number for EVV, SMC Update for Sandata EVV, Updated: MCG Auto-Authorization, Molina Quality Living Program Awardees, 2022 HEDIS Data Collection, Provider Training Sessions, Changes to PA Requirements, Did You Know: Pacify, Updated PA Guide, Provider Contract for Next Generation Medicaid, Ownership and Control Disclosure Form Requirements, American Academy of Pediatrics Spring Education Meeting, Molina of Ohio Check Runs, Improved Outcomes for People with Disabilities, Updated Sequestration Suspension and Reduction, Outpatient Therapy Services Reminder, COVID-19 Home and Point-of-Care Testing  April 2022 
Provider Bulletin - Special Edition: New Century Health, PA Code List  March 2022 
Provider Bulletin: It Matters to Molina Corner, MCG Auto-Authorization, UPDL: 30-Day Change Notice, Next Generation Medicaid, Outpatient Therapy Service, DSME Education for Medicaid, You Matter to Molina: PS Reps, MolinaCares Accord Webinar, 2022 HEDIS® Data Collection, MyChoice Debit Cards, COVID-19 Pfizer Codes, COVID-19 Test Kits, Provider Training Sessions, Changes to Provider Manual, Did You Know: Text4baby, Website Roundup, Q1 Provider Newsletter, Emailing PHI Securely, AAP Spring Education Meeting, Health Care Education, Sequestration Reduction, Maternal Health, Americans with Disabilities Act  March 2022
Provider Bulletin - Special Edition Behavioral Health: Notice of Changes to Prior Authorization Requirements, Prolonged Service Codes: 99354 and 99355, Ordering, Referring, and Prescribing Providers NPI, Behavioral Health Centralized Fax Numbers, Claim Reconsiderations, SUD Services PA Request Form, Billing Code Added for Pregnancy Report, PsychHub on the Molina Provider Website, Behavioral Health Provider Manual, Provider Enrollment in MITS, Non-Contracted BH Providers. Update to Definitive UDS Counts, Changing a Remittance Address, Changing a Service Location Address, BH Cash Advance Repayments, BH Limits, Audits and Edits  February 2022 
Provider Bulletin - Special Edition: Post-Acute Authorization Requirements  February 2022 
Provider Bulletin: It Matters to Molina Corner, Prior Authorization Changes, 2022 HEDIS Data Collection, COVID-19 Home and Point-of-Care Testing, Health Care Education: Improved Outcomes for People with Disabilities, You Matter to Molina: Get to Know Your Provider Representatives, Updated: Claims Hold on Prospective Payment System, Molina Quality Living Program Awardees, 2021: A Year in Review, Provider Training Sessions, Provider Manual Changes, Legacy Provider Portal, Ordering, Referring, and Prescribing Providers NPI, Updated Sequestration Suspension and Reduction, Maternal Health Training February 2022
Provider Bulletin - Special Edition: ProgenyHealth Partnership for NICU UM and CM, Updated: Post-Acute Authorization Requirements, COVID-19: Vaccination Program for 2022 January 2022
Provider Bulletin - Special Edition: Check Printing Error January 2022
Provider Bulletin: It Matters to Molina Corner, Claims Hold on Prospective Payment System, Updated Sequestration Suspension and Reduction, COVID-19 Vaccine Updates, Legacy Provider Portal, 2022 Provider Manuals, ProgenyHealth Partnership for NICU UM and CM, Modifier Requirements for HCPCS H0020, Behavioral Health Provider Manual, Post-Acute Authorization Requirements, Updated: Ordering, Referring, and Prescribing Providers NPI, Maternal Health Training, Provider Training Sessions, Changes to PA Requirements, Update to Definitive UDS Counts, Hospice Claims Value Codes, Evaluation and Management Services Billed with Rev. Code 0761, Availity Provider Secure Messaging, Reminder: EVV Providers January 2022

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