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Cómo apelar una denegación
¿Qué es una denegación? Una denegación significa que Molina Healthcare le indica a un proveedor y a usted que los servicios no se prestarán o que las facturas no serán pagadas. Si le denegamos un serv...
/members/ut/mem/medicaid/chip/quality/cna/appeal.aspx
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What is a Grievance
A grievance is an oral or written expression of dissatisfaction, including any complaint, dispute, request for reconsideration, or appeal made by a member.What types of problems might lead to you fili...
/members/ut/mem/medicaid/chip/quality/cna/grievance.aspx
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Revisión médica independiente
Los miembros pueden solicitar una revisión médica independiente (IMR, por sus iniciales en inglés) de un servicio de atención médica en disputa al Departamento de Atención de Salud Administrada (DMHC,...
/members/ut/mem/medicaid/chip/quality/cna/review.aspx
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Frequently Asked Questions
You can find answers to your questions below! Also, check out our glossary to look up any words that may be confusing. Don’t see your question? Just give us a call! Transparency in Coverage ...
/members/ut/mem/marketplace/resources/faq.aspx
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Special Enrollment
You can qualify for special enrollment prior to January 2015 if you’ve had a change in life event. This is known as the Special Enrollment Period. Life events include:Losing your job or having a chang...
/members/ut/mem/marketplace/resources/special-enrollment.aspx
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Case Management
Molina Healthcare staff will help you coordinate your careLiving with health problems and managing them can be hard. We offer special services and programs for adult and child members who need extra h...
/members/ut/mem/marketplace/coverd/services/casemngt.aspx
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What is a Complaint?
A complaint is an oral or written expression of not being satisfied. This can be any complaint. This can be a dispute. This can be a request for reconsideration. This can be a appeal made by a mem...
/members/tx/mem/CHIP/quality/cna/whatisgrievnc.aspx
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Care Coordination | Molina Healthcare Texas
Molina Healthcare staff will help you coordinate your careLiving with health problems and managing them can be hard. We offer special services and programs for adult and child members who need extra h...
/members/tx/hp/duals/coverd/hm/casemngt.aspx
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STAR+PLUS Benefits | Molina Healthcare Texas
All STAR+PLUS members can get the (2) Long-Term Care benefits if there is a functional need:Day Activity and Health Services (DAHS)Personal Attendant Services (PAS)Day Activity and Health ServicesLice...
/members/tx/hp/duals/coverd/wvrprg/disab.aspx
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STAR+PLUS Benefits
All STAR+PLUS members can get the two (2) Long Term Care benefits if there is a functional need:Personal Attendant Services (PAS)Day Activity and Health Services (DAHS) Day Activity and Health Service...
/members/tx/hp/duals/coverd/wvrprg/hiv.aspx