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Transportation
The following benefits are only available to Silver Plan Members Emergency Medical TransportationWe cover Emergency transportation (ambulance), or ambulance transport services provided through the “91...
/members/ca/mem/marketplace/coverd/services/transport.aspx
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Fraud
Molina Healthcare of California ("Molina") seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of federal and s...
/members/ca/mem/marketplace/quality/fraud.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/ca/mem/marketplace/resources/faq.aspx
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Timely Access to Care
Your doctor’s office should give You an appointment in the time frames listed below. Exceptions may apply to these timely access standards if the Department of Managed Health Care (DMHC) has found ex...
/members/ca/mem/marketplace/resources/timely-access-to-care.aspx
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Frequently Used Forms
Please click on a form below to view a PDF printable version. The files below are in PDF format ()   Claims Provider Dispute Resolution Request Form Prior Authorizations Behavioral Health Prior Au...
/providers/ca/marketplace/forms/fuf.aspx
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HIPAA Security
aHIPAA Security Standards for the Protection of Electronic Protected Health InformationThe Final Rule adopting HIPAA standards for the security of electronic protected health information was published...
/providers/ca/marketplace/hipaa/security.aspx
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HIPAA Transactions
HIPAA Standards for Electronic Healthcare TransactionsHIPAA required the Department of Health and Human Services (HHS) to adopt national standards for electronic healthcare transactions. All covered e...
/providers/ca/marketplace/hipaa/tcs.aspx
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HIPAA Transaction Readiness
Since HIPAA’s inception, Molina Healthcare has worked diligently and collaboratively with the broader healthcare community to achieve compliance with the federal HIPAA transactions requirements. Molin...
/providers/ca/marketplace/hipaa/tcs_readiness.aspx
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HIPAA 5010 Readiness
aMolina Healthcare’s HIPAA 5010 Readiness *Molina Healthcare is ready to test the 5010 versions of the HIPAA transactions with providers and other trading partners.  We look forward to working collabo...
/providers/ca/marketplace/hipaa/5010Readiness.aspx
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HIPAA Code Sets
The Federal HIPAA regulations issued by DHHS dictate that only approved code sets may be used in standard electronic transactions. The CMS site has official resources that define these standard code s...
/providers/ca/marketplace/hipaa/codesets.aspx