Statutory Reference Notice
STATUTORY REFERENCE: Chapter 551 of the Laws of 2006
Notice to Physicians on Software Product used to accept/edit claims
NOTICE
I...
There are several ways members or their authorized representative (including a provider on behalf of a member) can file a grievance with Molina:
By phone: (800) 424-5891
Monday - Friday 8 a.m. to 6 p...
Complaints and Grievances
If you are unhappy with your child’s medical care or the service your child is getting from Molina and/or its providers, you can file a complaint. You can file a complaint o...
Molina Healthcare uses a Preferred Drug List (PDL), which is a list of covered prescription drugs. It is reviewed and approved by doctors and pharmacists. You must get your prescriptions from a pharma...
Apelaciones
Si recibe una carta de denegación y no está conforme con nuestra decisión, puede presentar una apelación. Una apelación es una solicitud de la revisión de una acción. Una acción es cualqui...
*You may request printed copies of all content posted on our website.
What is a denial?
A denial means Molina Healthcare is telling a provider and you that services will not be provided (or they will...
Submitting Claims
As a participating provider with Molina Healthcare, you have established a contractual agreement to provide physical, behavioral and/or other long-term support services to our membe...
Appeal Process
You can file an appeal if Molina Healthcare denied, suspended, terminated, or reduced a requested service. This is called an adverse determination.
You have 90 days from the date o...
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