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HIPAA Code Sets
The Federal HIPAA regulations issued by DHHS dictate that only approved code sets may be used in standard electronic transactions. The CMS site has official resources that define these standard code s...
/providers/tx/duals/hipaa/codesets.aspx
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Fraud Prevention Tips
Molina Healthcare of Texas seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of federal and state authorities...
/providers/tx/duals/policies/fraud.aspx
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Policies
Molina has established Molina Clinical Policies (MCP) that function as one of the sets of guidelines for coverage decisions or determinations. MolinaClinicalPolicy.com includes the Molina-wide Clinica...
/providers/tx/duals/policies/policies.aspx
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Credentialing & Patient Safety
CredentialingMolina Healthcare has a duty to protect its members by assuring the care they receive is of the highest quality. One protection is assurance that our providers have been credentialed acco...
/providers/tx/duals/policies/safety.aspx
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Fraud Prevention Tips
Molina Healthcare of New Mexico ("Molina") seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of federal and s...
/providers/nm/marketplace/policies/fraud.aspx
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Case Management
Molina Healthcare staff will help coordinate your care Living with health problems and managing them can be hard. We offer special services and programs for members who need extra help with a health p...
/providers/sc/duals/resource/casemngt.aspx
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Nurse Advice Line
The Molina Nurse Advice Line is available to all participating medical groups, physicians, and Molina members 24 hours a day, 7 days a week and is staffed with Registered Nurses who are trained and av...
/providers/sc/duals/resource/nurseadvice.aspx
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Waivers
We want you to stay well and live independently. Molina Healthcare is dedicated to getting you the help and care you need. If you qualify, there are Waiver Programs available that provide additional s...
/providers/sc/duals/resource/waivers.aspx
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Rights & Responsibilities
Member RightsGet medical care regardless of your race, color, national origin, disability (mental or physical), sex, religion or age. If you feel you have been treated unfairly or discriminated agains...
/providers/ut/medicaid/policies/provpolicies.aspx
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Fraud Prevention
Molina Healthcare of Utah seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members, and supports the efforts of federal and state authorities...
/providers/ut/medicaid/policies/fraud.aspx