Washington Marketplace - Updates and Events

2025

Prior Authorization Code Matrix Update Effective July 1, 2025

Q1 2025 Provider Newsletter Available Online

Clinical Practice and Preventative Health Guidelines Update: February 3, 2025

2024

Q4 2024 Provider Newsletter Available Online

Clinical Practice and Preventative Health Guidelines Update: November 18, 2024

Pertussis Increase in WA Notice: November 18, 2024

Q3 2024 Provider Newsletter Available Online

Preventive Health Guidelines Update: September 13, 2024

Antidepressant Medication Management (AMM) Provider Newsletter: August 30, 2024

Preventive Health Guidelines Update: August 28, 2024

Prior Authorization Code Matrix Update Marketplace Effective October 1, 2024

Chelan County Horselake Wildfire - Disaster Response

Evolent, Formerly New Century Health - Oncology/Cardiology

Preventive Health Guidelines Update: August 6, 2024

Q2 2024 Provider Newsletter Available Online

Physician Office Laboratory Testing Update

Preventive Health Guidelines Update: June 12, 2024

Prior Authorization Code Matrix Update Effective July 1, 2024

Webinar Opportunity: Cultural Humility and Cultural Competency – June 20 and June 27

Preventive Health Guidelines Update: April 12, 2024

Webinar Opportunity - Cultural Humility & Collectivism vs Individualism - April 18 and June 13

Provider Bulletin: Optum-Change Healthcare Outage Update April 5, 2024

Q1 2024 Provider Newsletter Available Online

Provider Bulletin: Optum-Change Healthcare Outage Update March 18, 2024

Tribal Authorization Process

Provider Bulletin: Optum-Change Healthcare Outage Update March 8, 2024

Provider Bulletin: Optum-Change Healthcare Outage Update February 29, 2024

Provider Bulletin: Optum-Change Healthcare Outage

Risk Adjustment Medical Record Review

How to Correct a Claim in Availity

Clinical Practice Guidelines Update: January 11, 2024

CMS Final Rule for CY24 - Behavioral Health Changes Effective January 1, 2024

Syphilis Screening

Live Availity Essential Trainings: January and February 2024

Advanced Imaging ePortal Submissions

2023

Fall 2023 Provider Newsletter Available Online

In-Network Clinical Laboratory Reminder

2024 Q1 Greater Columbia Provider Forum: January 9, 2024

Reimbursement Policy for Durable Medical Equipment (DME) Rental v. Purchase Effective: February 15, 2024

Secure Messaging from Claim Status Screen Enabled in Availity Essentials Portal

Submit and Track Your Appeals on Availity Essentials

Explanation of Payment Refund and Forwarding Balance Reporting Enhancement

Your Feedback is Important! Molina Healthcare 2023 Provider Satisfaction Survey

Prior Authorization Change Effective January 1, 2024

Full Matrix - Prior Authorization Change Effective January 1, 2024

Preventive Health Guidelines (PHGs) Update: November 6, 2023

Process Update – Marketplace Authorizations Fax Number Update Effective November 1, 2023

Marketplace Allergy Testing Change Effective January 1, 2024

Preventive Health Guidelines (PHGs) Update: October 2, 2023

Provider Tips to Increase Flu Vaccinations CY23-24: October 2023

Live Availity Essentials Trainings: October, November and December 2023

Effective Immediately: Molina's Provider Online Directory to Display Maximum of Five Service Locations Per Provider

Summer 2023 Provider Newsletter Available Online

Live Availity Trainings: September and October 2023

Lynx Healthcare Pain Management Clinic Closed: Effective September 8, 2023

Molina 2023 Q4 Spokane Provider Workshop & Luncheon: October 10, 2023

Updated Marketplace PO Box for Provider Claim Disputes and Appeals

Wildfires-Molina's Disaster Response

Preventive Health Guidelines (PHGs) Update: August 4, 2023

August and September Live Availity Trainings

Availity Essentials Core Features

Prior Authorization Change Effective October 1, 2023

Explanation of Payment Refund and Forwarding Balance Reporting Enhancement

Preventive Health Guidelines (PHGs) Update: July 13, 2023

July and August 2023: Live Availity Essentials Trainings

Live Availity Essentials Trainings: June and July 2023

Molina's Peer-to-Peer Review Timeframe Updated: Effective July 1, 2023

Preventive Health Guidelines (PHGs) Update: April 2023

End of COVID-19 Public Health Emergency Information for Marketplace Providers

Availity Essentials is Molina Healthcare's Exclusive Provider Portal Effective June 22, 2023

Prior Authorization Change Effective July 1, 2023

Live Availity Trainings: May and June 2023

New Century Health Updated eFax Numbers

Availity Essentials Migration Schedule Change/Update

Spring 2023 Provider Newsletter Available Online

Explanation of Payment Refund Reporting Enhancement in ECHO

Clinical Practice Guidelines and Preventative Health Guidelines Update: February 23, 2023

Avalon Laboratory Benefit Management Program Updated Launch Date: 3/23/2023

Live Availity Trainings: February and March 2023

Clinical Practice and Preventative Health Guidelines Update

Prior Authorization Change Effective April 1, 2023

Effective February 1, 2023 Molina Healthcare to Partner with Healthmap Solutions, Inc.

2022

New Century Health Oncology Prior Authorization Effective March 1, 2023

Reminder: 2022 Provider Satisfaction Survey

Change Healthcare ProviderNet Sunsetting Notice

Fall 2022 Provider Newsletter Available Online

Provider Tips to Increase Flu Vaccinations - CY22-23 Flu Season

Prior Authorization Change Effective January 1, 2023

Notice of Change in Process for Incorrect Paper Claims Address

Reminder: New Century Health Oncology Prior Authorization Effective November 1, 2022

Change Healthcare Settlement Advocate Migration with ECHO Health Inc.

Molina Healthcare 2022 Provider Satisfaction Survey

Guidelines and Instructions for Paper Claim Submissions

Set Up Your Payment Preference with ECHO Health, Inc. Today!

ProviderNet Service Portal Outage

Molina Marketplace Notice of Regulatory Updates

Spring 2022 Provider Newsletter Available Online

Update Regarding Molina's Peer-to-Peer Process and Reconsideration Requests Effective July 25, 2022

Prior Authorization Change Effective July 1, 2022

Payment Policy Update: Outpatient Definitive and Presumptive Drug Testing ON HOLD

Winter 2022 Provider Newsletter Available Online

Update to Comply with the Consolidated Appropriations Act of 2021

Availity Features

Legacy Provider Portal New User Registration Ending

MCG Cite AutoAuth Effective February 16, 2022

Prior Authorization Effective April 1, 2022 - Biofeedback

Prior Authorization Effective April 1, 2022

TeleBehavioral Health Training

Check Printing Error

2021

Fall 2021 Provider Newsletter Available Online

Provider Tips to Increase Flu Vaccinations

Flooding in WA - Disaster Response

Reminder: 2021 Provider Satisfaction Survey

Outpatient Definitive and Presumptive Drug Testing Update Effective January 1, 2022

Prior Authorization Changes Effective January 1, 2022

Summer 2021 Provider Newsletter Available Online

Fax Number Change for Marketplace Authorizations Effective September 27, 2021

2021 Provider Satisfaction Survey

Partial Approval/Partial Denial Process Effective August 2021

Change to Cardiology Prior Authorization Process Effective October 1, 2021

Wildfire-Disaster Response

Prior Authorization Change Effective October 1, 2021

Prior Authorization Change Effective October 1, 2021-Substance Use Disorder

Molina Healthcare is Moving to a New Online Provider Directory

2021 Clinical Practice and Preventive Health Guidelines

Spring 2021 Provider Newsletter Available Online

Molina is Moving to a New Online Provider Directory

Dive in to Availity's Capabilities with a Free Webinar

Molina is Changing to Availity - Free 30-Minute Webinar Training

Fax Number Change for Marketplace Authorizations Effective May 24, 2021

Prior Authorization Change Effective July 1, 2021

Online and Printed Provider Directory Display Update

COVID-19 Pharmacy Benefits for Molina WA Marketplace

Molina Healthcare Provider Toolkit

Winter 2021 Provider Newsletter Available Online

Delay to New Century Health (NCH) Transition for Cardiology Prior Authorization

Prior Authorization Change General Hematology/Oncology Effective February 3, 2021

Change to Cardiology Prior Authorization Process Effective April 1, 2021

Prior Authorization Change Effective April 1, 2021

2020

Prior Authorization Change Effective January 1, 2021

FAQs for MCG Criteria Effective January 31, 2021

MCG Provider Notification Effective January 31, 2021

COVID-19 Provider Resources

Prior Authorization Change Medication Assisted Treatment Effective January 1, 2021

Prior Authorization Change Behavioral Health Substance Use Disorder Effective January 1, 2021

Prior Authorization Change Applied Behavioral Analysis Effective January 1, 2021

New Clinical Practice Guideline Updates

CDC Guidelines for COVID-19

Molina Expands Pharmacy Benefit Coverage for Continuous Glucose Monitors

E/M Code Edit Reviews Effective June 1, 2020

Marketplace Prior Authorization Changes Effective April 1, 2020

2019

Update on Molina's Peer-to-Peer and Reconsideration Process Effective November 4, 2019

Saying It Out Loud Spokane

Optum PrePayment Claim Reviews

Prior Authorization Changes Marketplace Effective October 1, 2019

EDC Analyzer Sample Provider Notification Letter 2019

Behavioral Health Prior Authorization Suspended Eligibility Effective January 18, 2019

2018

Prior Authorization Changes Cardiac Effective January 1, 2019

Prior Authorization Changes Genetic Testing Effective January 1, 2019

Prior Authorization Changes Joint Replacement Effective January 1, 2019

Prior Authorization Changes CGM Supplies Effective January 1, 2019

Prior Authorization Changes Biosimilar Drugs Effective January 1, 2019

Prior Authorization Changes Genetic Testing Effective July 1, 2018

2016

Advance Care Planning Initiative December 2016

2015

Tribal Claims Reviewed

Contraceptive 12-Month Supply Encouraged

Helpful Tips For Submitting Autism Evaluation/ABA Therapy Prior Authorization Request Effective July 1, 2015

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