The Healthcare Services (formerly Utilization Management) Department conducts inpatient review on inpatient cases and processes Prior Authorizations/Service Requests. The Healthcare Services (HCS) Dep...
Molina maintains access to care standards and processes for ongoing monitoring of access to health care (including behavioral health care) provided by contracted primary PCPs (adult and pediatric) and...
Molina Healthcare of Mississippi 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 auth...
The Patient Safety Program identifies appropriate safety projects and error avoidance for Molina Healthcare members in collaboration with their primary care providers.Molina continues to support safe ...
Molina Healthcare's Health Education programs will be incorporated into the Member's treatment plan to address the Member's health care needs. Primary prevention programs may include smoking cessatio...
Opioid toxicity and abuse is a public health concern in the United States. There has been an alarming increase in the number of opioid-related deaths in recent years. In 2016, the United States saw mo...
The Molina Clinical Policies accessible on this page are specific to Molina Healthcare of Ohio Medicaid members only and can be used as a tool to guide you in your medical decisions. Note: For Medicar...
Marketplace Benefit Interpretation Policies
For Codification, please click here (for Marketplace only)
For Clinical Policies, please click here (all LOBs)
For PA Lookup Tool, please click here
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Ohio has designated Provider Relations Representatives based on provider types to help answer your questions more efficiently or connect you to training opportunities.
Contact information for non-ho...
