Join Our Provider Network

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Join Our Provider Network

Thank you for your interest in joining Molina Healthcare of Mississippi’s network of participating providers. Molina Healthcare of Mississippi currently provides coverage to MississippiCAN (Medicaid), CHIP and Marketplace Members. 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.

Note:To join Molina Healthcare of Mississippi’s MississippiCAN (Medicaid) network, you must be enrolled as a Mississippi Medicaid provider and have an active Mississippi Medicaid ID number.

Follow These Steps to Join Our Network

Step One – Connect

Points of contact and the process for joining our network will differ depending on the type of provider that you are. Please follow the instructions below for your provider type.

Dental and Hearing Providers
Please contact our dental and hearing vendor, Avesis, for participation at (833) 282-2419 or by visiting Note: If you are an oral surgeon or facility, you must apply for participation with both Molina Healthcare of Mississippi and Avesis. Please complete a Contract Request Form and submit to to begin the Molina Healthcare of Mississippi process (outlined in Steps 2 through 4 below) and also contact Avesis directly
Vision Providers
Please contact our vision vendor, March Vision Care, for participation at (844) 606-2724 or by visiting
Pharmacy Providers
Please contact our Pharmacy benefits manager, CVS Pharmacy, by visiting CVS website here:Join CVS Caremark Network.
All Other Providers
Please complete a Contract Request Form Form and submit to

Step Two – Documentation

If your Contract Request Form is accepted, our Provider Contracting department will provide you with credentialing and contracting documents that must be completed. Documents you receive may differ depending on provider type, and may include:

  • Provider Agreement;
  • Provider Information Form;
  • Ownership and Control Disclosure Form;
  • W-9;
  • Practitioner Application (if practitioner does not have an updated and attested CAQH profile); and/or
  • Health Delivery Organization Credentialing Application

Upon receipt of completed documents, Provider Contracting will then begin the credentialing process.

Step Three – Credentialing

Provider Contracting will work with Molina’s Credentialing department to credential the facilities and/or practitioners included in your completed documents. The credentialing process may take up to 90 calendar days to complete. Once credentialing is completed, you will receive a notification from Molina’s Credentialing department.

Note: You can help the credentialing process run smoothly, and perhaps even reduce the time it takes to credential, by making sure that you:

  • Complete and update practitioner CAQH information; and
  • Properly complete and sign the Ownership and Control Disclosure form

Step Four – Contract

The final step will be for Molina to countersign your Provider Agreement and provide you with a signed copy. Credentialed facilities and/or practitioners will also be loaded into Molina’s claims payment system as in-network providers. The in-network effective date for each facility and/or practitioner will be the date of credentialing completion, which will be included in the notification that you will receive from Molina’s Credentialing department (referenced above in Step 3 – Credential).

Already a participating provider with Molina Healthcare of Mississippi but would like to join an existing participating group? Please complete a Provider Information Update Form and submit to Adding a Provider to a Participating Group? Please complete a Provider Information Update Form and submit to .

Forms & Documents

Visit Forms & Documents, download what you need when you need it.