Here you can find all your provider forms in one place. If you have questions or suggestions, please contact us.
Provider Services Phone: (855) 838-7999
Provider Relations Email: SWHProviderRelations@...
Appeals
Grievance Consent Form
Provider Appeal Form
Behavioral Health
Behavioral Health Prior Authorization Form
Combined MCE Behavioral Health Provider Primary Care Provider Communication For...
Model of Care
Model of Care Provider Training Quick Reference Guide
2026 Model of Care Training
2026 Model of Care Attestation
Resources for Integrated Care
Resources for Plans & Provi...
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Utilization Management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.C...
Provider Contracting and Credentialing
To become a participating Molina provider, please submit a completed Contract Request Form and a current W-9 to MHIDProviderContracting@MolinaHealthcare.com.
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Provider Relations
Molina Healthcare maintains a strong commitment to meeting the needs of our providers. Our Provider Relations team is dedicated to enhancing network provider relationships and ensur...
