What’s coveredMolina Healthcare will provide you with a case manager who will have direct contact with you and your family. They will discuss the services you need with you, your caregiver and your pr...
Fraud, Waste and Abuse
Molina Healthcare’s Fraud, Waste and Abuse Plan benefits Molina, its employees, members, providers, payers and regulators by increasing efficiency, reducing waste, an...
Does Passport offer Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)?
Yes. Passport offers ERA/EFT through Change Healthcare, who has contracted with ECHO Health for these serv...
For questions about any of the following areas, please select the appropriate link:
Submitting Electronic: Claims, Referral Certification and Authorization
(866) 409-2935
Email Directly: EDI.Claims@Mo...
What is Healthy Connections Prime?It's a program to provide better, coordinated health care for people with both Medicare and Medicaid, often called dual eligible or duals. Plans that participate in H...
All clinical practice guidelines are based on scientific evidence, review of the medical
literature, or appropriately established authority, as cited. All recommendations are
based on published conse...
Molina’s UM Department is designed to provide comprehensive health care management by managing utilization services and benefits effectively and efficiently.
UM Decision Making
Molina follows a h...
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
...
Q. How do I get medical services?
A. You should get all health care from Molina Healthcare providers. Your Provider Directory lists all the providers that are part of the plan. If you need a printed ...
