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Join Molina Healthcare of Michigan's Network
Thank you for your interest in joining Molina Healthcare of Michigan's provider network. Currently, we provide coverage to Medicaid, Medicare (DSNP and Medicare Advantage Prescription Drug plan), MI H...
/providers/mi/medicaid/comm/Join-Molina-Healthcare-of-Michigan-Network.aspx
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Submitting EDI Transactions
Types of EDI Transactions Electronic Data Interchange (EDI) functionality is utilized by Molina to complete several types of ASC X12N Version 5010 transactions, including: Claims Submission (83...
/providers/mi/duals/ediera/edi/editrans.aspx
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Submitting EDI Transactions
Types of EDI Transactions Electronic Data Interchange (EDI) functionality is utilized by Molina to complete several types of ASC X12N Version 5010 transactions, including: Claims Submission (83...
/providers/mi/medicaid/ediera/edi/editrans.aspx
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Frequently Asked Questions
Can I submit COB claims electronically? Yes, Molina and our connected Clearinghouses fully support electronic COB. Do I need to submit a certain volume of claims to send EDI? No, any number of claims...
/providers/mi/medicaid/ediera/edi/faq.aspx
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HIPAA 5010 Readiness
aMolina Healthcare’s HIPAA 5010 Readiness *Molina Healthcare is ready to test the 5010 versions of the HIPAA transactions with providers and other trading partners.  We look forward to working collabo...
/providers/mi/medicaid/hipaa/5010Readiness.aspx
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HIPAA Code Sets
The Federal HIPAA regulations issued by DHHS dictate that only approved code sets may be used in standard electronic transactions. The CMS site has official resources that define these standard code s...
/providers/mi/medicaid/hipaa/codesets.aspx
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Unique Identifiers
Molina Healthcare has implemented the HIPAA NPI requirements. Beginning May 23, 2008, HIPAA standard transactions must include NPIs.  No legacy identifiers (other than the billing/pay-to provider's Ta...
/providers/mi/medicaid/hipaa/npi.aspx
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HIPAA Transactions
HIPAA Standards for Electronic Healthcare TransactionsHIPAA required the Department of Health and Human Services (HHS) to adopt national standards for electronic healthcare transactions. All covered e...
/providers/mi/medicaid/hipaa/tcs.aspx
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HIPAA Transaction Readiness
Since HIPAA’s inception, Molina Healthcare has worked diligently and collaboratively with the broader healthcare community to achieve compliance with the federal HIPAA transactions requirements. Molin...
/providers/mi/medicaid/hipaa/tcs_readiness.aspx
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Fraud Prevention Tips
Molina Healthcare seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members, and supports the efforts of federal and state authorities in thei...
/providers/mi/medicaid/policies/fraud.aspx
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