October 2, 2024
2024 Member Care Gaps & EMR Messaging
Molina Healthcare of Wisconsin, Inc. (Molina) partners with Centauri Health Solutions to send messages into electronic medical records (EMRs) t...
Molina Healthcare uses the Healthcare Effectiveness Data and Information Set (HEDIS®) tool every year for quality reporting. This is done by looking at the type of care and services provided. Along w...
The Healthcare Services (formerly Utilization Management) Department conducts inpatient review on inpatient cases and processes Prior Authorizations/Service Requests. The Healthcare Services (HCS) Dep...
Participation Guidelines and Standards of Care
Provider Guidelines:
All Participating Providers are expected to:
Perform duties in their area of specialty.
Provide preventive care services, ...
Quality Improvement Activities To meet the purpose, goals and scope of this program, QI activities as reflected in the QI Work Plan will be focused in the following areas.Improvement of the health sta...
Participation Guidelines and Standards of Care
Provider Guidelines:
All Participating Providers are expected to:
Perform duties in their area of specialty.
Provide preventive care services, i...
To find the Member Rights and Responsibilities, please click here.
Your Membership Rights
As a member of Molina Healthcare, you have the following rights:
To receive all the services t...
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Utilization Management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.C...
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