Provider appeals and claims disputes in California

If you, as a provider, disagree with a decision regarding Molina health benefits for your member, you can submit an appeal for review. During the appeal process, Molina will notify you of your rights, qualified professionals will review your case, and Molina will communicate the outcome, including further options if the denial is upheld.

Provider claim disputes

Providers can request a review of previously processed claims, following Molina’s established redetermination procedures. Our procedures ensure that we handle claims disputes and adjustments promptly and transparently.

For more information, see our Provider Dispute Policies.