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Utilization management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.
Clin...
Participation Guidelines and Standards of CareProvider Guidelines:All Participating Providers are expected to:Perform duties in their area of specialty.Provide preventive care services, including well...
One of the goals of Molina Healthcare Utilization Management (UM) department is to render appropriate UM decisions that are consistent with objective clinical evidence. To achieve that goal, Molina He...
Molina maintains access to care standards and processes forongoing monitoring of access to health care (including behavioral health care)provided by contracted primary PCPs (adult and pediatric) and ...
Thank you for your interest in joining Molina Healthcare of Michigan's provider network. Currently, we provide coverage to Medicaid, Medicare (DSNP and Medicare Advantage Prescription Drug plan), MI H...
We’re committed to offering our Senior Whole Health members access to quality providers in their communities, and we want you to join us!
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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...
Submitting Claims
As a participating provider with Molina Healthcare, you have established a contractual agreement to provide physical, behavioral and/or other long-term support services to our membe...
