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...
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 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...
Appeals
Grievance Consent Form
Provider Appeal Form
Behavioral Health
Behavioral Health Prior Authorization Form
Combined MCE Behavioral Health Provider Primary Care Provider Communication For...
The Provider Bulletin publication is Molina Healthcare of California's (MHC) primary communication method with our Provider/Practitioner community.
Information types include:
...
Beginning July 1, 2024, a Single Pharmacy Benefit Administrator (SPBA) will begin providing pharmacy services for all health plans for Medicaid and CHIP beneficiaries. Gainwell will be responsible f...
What’s Covered
You can go to any OB/GYN doctor in your Primary Care Physician’s (PCP) network and get out of plan Certified Nurse Midwife (CNM) services without a prior authorization. You can also get...
