Utilization Management (UM) Program
Page ContentMolina’s UM Department is designed to provide comprehensive health care management by managing utilization services and benefits effectively an...
For questions about any of the following areas, please select the appropriate link:
Submitting Electronic: Claims, Referral Certification and Authorization
1-866-409-2935
Email Directly: EDI.Claims@Mo...
Types of EDI Transactions
Electronic Data Interchange (EDI) functionality is utilized by Molina to complete several types of ASC X12N Version 5010 transactions, including:
Claims Submission (83...
Does Molina offer Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)?
Yes. Molina Healthcare offers ERA/EFT through Change Healthcare, who has contracted with ECHO Health for thes...
For questions about any of the following areas, please select the appropriate link:
Submitting Electronic: Claims, Referral Certification and Authorization
Email Directly: EDI.Claims@MolinaHealthcare....
Types of EDI Transactions
Electronic Data Interchange (EDI) functionality is utilized by Molina to complete several types of ASC X12N Version 5010 transactions, including:
Claims Submission (83...
Molina Clinical Policies
Molina has established Molina Clinical Policies (MCP) that function as one of the sets of
guidelines for coverage decisions or determinations, which are available at
www.mo...
