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Utilization Management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.C...
June 24, 2024
Molina/My Choice Wisconsin Integration Update for June 2024
Important Reminder!
On Monday, July 1, all My Choice Wisconsin Medicaid SSI and BadgerCare Plus (BC+) products...
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Submitting Claims
As a participating provider with Molina Healthcare, you have established a contractual agreement to provide phy...
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...
Important update for providers!
Effective Jan. 1, 2026, Molina Healthcare of Ohio, Inc. will discontinue fax submissions of prior authorizations (PA). All requests for PA must be submitted through the...
Utilization management (UM)
We use evidence-based clinical practice guidelines when making decision about members’ care.
Clinical practice guidelines address preventive, acute or chronic and behaviora...
NEW UM PROCESS EFFECTIVE 10/1/24:
Sending sufficient clinical information to support a requested PA is an expectation. Beginning 10/1/24, Molina Healthcare of Iowa asks for clinical information one ti...
