Continuity of Care and Provider-to-Provider CommunicationAs medical practice becomes more complex and demanding, coordinating care between various providers involved in a patient's care is a challenge...
Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.
As our partn...
The Marketplace Prior Authorization Guide is a listing of codes that allows contracted providers to determine if a prior authorization is required for a health care service and the supporting document...
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...
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...
Care CoordinationAs medical practice becomes more complex and demanding, coordinating care between various providers involved in a patient’s care is a challenge. It is not unusual to hear from paitent...
Page Content
Long term services and supports are Medi-Cal benefits that help members with ongoing personal care needs. Molina Dual Options will work with the member's doctors and long term services ...
Thank you for your interest in joining Molina Healthcare of Illinois' provider network. We currently provide coverage to HealthChoice Illinois (Medicaid), MLTSS, Medicare-Medicaid Program (Dual Option...
Medicaid entities/Providers are required to report, return, and explain any overpayments they have received to the New York State Office of the Medicaid Inspector General (OMIG) Self- Disclosure Prog...
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