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Utilization Management
Utilization Management (UM) Program Page ContentMolina’s UM Department is designed to provide comprehensive health care management by managing utilization services and benefits effectively an...
/providers/common/marketplace/resource/Utilization-Management.aspx
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Long Term Services and Supports
Page Content Long term services and supports are Medi-Cal benefits that help members with ongoing personal care needs. Molina Dual Options will work with the member's doctors and long term services ...
/providers/ca/medicaid/resource/services.aspx
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Claims Submissions
@media only screen and (max-width: 767px) { .arrow_btn_img { right: -10px !important; } } .bullet_list li{ display: list-item; list-style-type: disc !important; } ...
/providers/ma/swh/claims/submission.aspx
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Provider Manual Forms
Welcome to Molina Healthcare of Washington, Inc. Enclosed please find your Molina Provider Manual, written specifically to address the contractual and regulatory requirements of delivering health care...
/providers/wa/medicaid/manual/provider_manual.aspx
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Rights & Responsibilities
Member Rights and Responsibilities Apple Health (AH) and Integrated Managed Care (IMC) Member Rights Help make decisions about your health care, including mental health and substance use disord...
/providers/wa/medicaid/policies/provpolicies.aspx
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Member Rights and Responsibilities
Member RightsGet information about the health plan, its services, its providers, and members' rights and responsibilities. To make recommendations regarding the members' rights and responsibilities po...
/providers/mi/medicaid/policies/rights.aspx
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Scope of Program Activities
The Molina Healthcare QI Program encompasses the quality of acute, chronic and preventive health care and service provided in both the inpatient and outpatient setting to our population as determined ...
/providers/mi/medicaid/resource/qi_scope.aspx
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QI Accountability
 Organizational Structure Supporting Quality Improvement: AccountabilityThe Board of DirectorsMolina Healthcare of Michigan's Board has ultimate authority and responsibility for the quality of care an...
/providers/mi/medicaid/resource/qi_account.aspx
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QI Strategy
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...
/providers/mi/medicaid/resource/qi_strategy.aspx
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Member Rights and Responsibilities
 To find the Member Rights and Responsibilities, please click here.   Member Rights Get information about the health plan, its services, its providers, and members' rights and responsib...
/providers/mi/marketplace/policies/rights.aspx
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