The Healthcare Services (formerly Utilization Management) Department conducts inpatient review on inpatient cases and processes Prior Authorizations/Service Requests. The Healthcare Services (HCS) Dep...
Claim Management for Missing or Incorrect Member Information Effective December 7, 201801/03/19Molina Healthcare would like to notify our provider partners of a change to the management of claims subm...
Participation Guidelines and Standards of Care
Provider Guidelines:
All Participating Providers are expected to:
Perform duties in their area of specialty.
Provide preventive care services, i...
If you have a complaint, we encourage you to first call Member Services. We will try to resolve any complaint that you might have over the phone. If you request a written response to your phone compla...
As a Molina Medicare member, you have certain rights and responsibilities. Molina Medicare has listed them below. Understanding your rights and responsibilities will assist your effort to work wit...
Q. What is a drug formulary (list of drugs)?A.Do you ever worry about how much your prescription drug will cost? Did you know that Molina Healthcare has a list of drugs that it pays for? This is calle...
Grievance ProcessYou can file a grievance with Molina Healthcare. If you are not happy with the health plan, this is called a grievance. You can also file a grievance if you are not happy with one of...
We want to give you good care!Molina Healthcare works with our providers to give you good health care. We look at your member benefits and make choices about care based on what you need. We want you t...
We want to give you good care!
Molina Healthcare works with our providers to give you good health care. We look at your member benefits and make choices about care based on what you need. We want you ...
