Appeals
If you receive a denial letter and do not like the choice we made, you can file an appeal. An appeal is a request to review an action or denial. An action is any denial that is:
Limited
...
Molina provides pediatric vision services to members under the age of 19. Pediatric Vision ServicesVision Exam (screening and eye exam, limited to one exam each calendar year)Prescription Glasses Stan...
Molina provides pediatric vision services to members under the age of 19. Pediatric Vision ServicesVision Exam (screening and eye exam, limited to one exam each calendar year)Prescription Glasses Stan...
Clinical practice guidelines are documents which seeks to guide decisions about the diagnosis and treatment of certain health conditions. Clinical practice guidelines are based on scientific evidence,...
Avēsis administers MississippiCAN and CHIP Dental benefits for Molina Healthcare of Mississippi.
Dental Claims
Please note that when submitting a dental claim to Avēsis, via the provider portal, clea...
Medical Necessity Criteria
Information sources used to determine benefit coverage and medical necessity include AHCCCS state coverage policies (AMPM/ACOM), MCG, Molina proprietary guidelines, national...
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!
T...
HIPAA Security Standards for the Protection of Electronic Protected Health Information
The Final Rule adopting HIPAA standards for the security of electronic protected health information was published...
HIPAA Standards for Electronic Health Care Transactions
HIPAA required the Department of Health and Human Services (HHS) to adopt national standards for electronic health care transactions. All cover...
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...
