Provider Contracting and Credentialing
Provider Information Update Form
Practitioner Enrollment Application
Disclosure of Ownership and Control
Provider Contract Request Form
Prior Authorizatio...
Prior Authorization Code Lookup Tool
Effective February 1, 2026, Molina will no longer accept fax submissions for authorization requests in Michigan. Digital requests through the Availity portal will ...
Important update for providers!
Effective Jan. 1, 2026, Molina Healthcare of Ohio, Inc. will discontinue fax submissions of prior authorizations (PA). All requests for PA must be submitted through the...
PCP Member Dismissal Form
PCP Member Dismissal Form
Prior Authorization Forms and Codification Matrix
Prior Authorization Guide/Authorization Form
Prior Authorization Form Private Duty/Attendant ...
One of the goals of Molina Healthcare Utilization Management (UM) department is to render appropriate UM decisions that are consistent with objective clinical evidence. To achieve that goal, Molina He...
Claim Management for Missing or Incorrect Member Information Effective December 7, 201801/03/19Molina Healthcare would like to notify our provider partners of a change to the management of claims subm...
Please familiarize yourself with the Drug Formulary as you prescribe medications for Molina Healthcare members. Thank you for your cooperation.
Preferred Drug List (PDL) & Rx Prior Authorization Form...
Does Molina offer Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)? Yes. Molina Healthcare offers ERA/EFT with our contracted vendor solution ProviderNet. Please refer to EDI Enr...
