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...
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The files below are in PDF format ()
Claims
Provider Dispute Resolution Request Form
Prior Authorizations
Behavioral Health Prior Au...
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...
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...
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...
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...
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...
IntroductionMolina Healthcare of Michigan serves Michigan members in counties throughout Michigan. Molina Healthcare of Michigan has served Medicaid patients since 2000. For all plan members, Molina H...
Prior Authorization Guide
Page Content
The Marketplace Prior Authorization Guide is a listing of codes that allows contracted providers to determine if a prior
authorization is required for a heal...
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...
