Please click on a form below to view a PDF printable version.
The files below are in PDF format ()
Provider Contracting
Contract Request Form
Provider Demographics
Change of Information Form
P...
Molina Allowed In-Office Lab Test List, Effective 1.1.19
Contract Request Form
Change of Information Form
LTSS & Home and Community Based Services Quick Reference Guide
Claims
Claims Inquiry/Appeal ...
Note: The Health Care Authority (HCA) implemented the Apple Health Preferred Drug List (PDL) on January 1, 2018. All managed care plans and the fee-for-service program serving Apple Health clients wil...
Appeals
Grievance Consent Form
Provider Appeal Form
Behavioral Health
Behavioral Health Prior Authorization Form
Combined MCE Behavioral Health Provider Primary Care Provider Communication For...
Page Content
Welcome!
Molina Healthcare of Ohio's "You Matter to Molina" program prioritizes connecting directly with our entire network of providers and supporting their efforts to deliver hig...
#accordion ul{
margin-left:45px;
}
#accordion ul li{
list-style: disc;
}
#accordion ul li ul li{
list-style: circle;
}
#accordion ul li ul li ul li{
list-s...
For Pharmacy forms, please go to our Forms page.
VA Medicaid 90-Day Drug List Update
The Department of Medical Assistance Services (DMAS) implemented a new permanent policy allowing ...
