There are two types of plans: Zero Cost or Limited Cost Sharing.
Zero Cost Sharing Plans
American Indians and Alaskan Natives (AIAN) with household incomes between 100% Federal Poverty Level - 300% Fe...
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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...
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...
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Utilization management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.
Clin...
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For all your Non-Emergent Medical Transportation (NEMT) needs, please contact MTM at (844) 879-7341 (TTY/TDD: 711) or call Member Services at (833)...
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...
The (UM) Department conducts inpatient review on inpatient cases and processes Prior Authorizations/Service Requests. Participating Providers are encouraged to interact with Passport’s UM Department e...
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...
