Preventive health guidelines can be beneficial to the provider and his/her patients. Guidelines are based on scientific evidence, review of the medical literature, or appropriately established authori...
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...
The guidelines below were reviewed and adopted by the Molina Complete Care (MCC) National Quality Improvement Committee. Committee approval dates are shown for 2015 and beyond. All guidelines are rev...
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...
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Molina supports our Providers, and as such would like to highlight the many benefits ERA/EFT:
Providers get faster payment (processing can tak...
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Utilization management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.
Clin...
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