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you're part of
the Molina Family

“I love working with Molina, their claim department is responsive and efficient”

Dr. Marina Jones

 
Alert!
The COVID-19 pandemic is rapidly evolving. Molina would like to share resources and updates with our provider partners. Learn More.

 

Welcome, Florida Healthcare Providers

Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.

As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.

If you have any questions, please call Provider Services at 1-855-322-4076.

 

Telehealth Vendor Update for All LOB's Effective 04/24/20

Please be advised that we're increasing the scope of our Telemedicine services to include MMA, as well as providing telehealth for adults by expanding Teladoc as a Telehealth Vendor for all Lines of Business (MMA/MCR and MP) as of April 24, 2020.

For more information, please contact Teladoc at: https://www.teladoc.com/ or Molina Healthcare at 855-322-4076.

Submitting Disputes via the Portal to Stop the Spread of COVID-19

Molina Healthcare takes the health of our members, providers, and employees alike, very seriously. As we are aware, COVID-19, more commonly known as Coronavirus is of the utmost concern globally. We do know that COVID-19 is an airborne virus that can be spread when someone coughs, sneezes or talks.

For any providers who need to submit any dispute, please submit via the Provider Web Portal. For detailed instructions on how to submit a dispute, please review the Web Portal Quick Reference Guide located on our website at www.MolinaHealthcare.com or on the web portal under the "Training" link.

Submitting disputes through the portal will reduce the spread of the virus by alleviating the risk of handling potentially contaminated documents as well as improved efficiency and reduced cost to the provider.

Please take the necessary precautions to ensure that you, your staff, and patients remain healthy and help us remain vigilant to curb the spread of this virus.

If you have questions, please contact Molina Healthcare at: 855-322-4076

ATTENTION PROVIDERS!!!

Providers should use QUEST DIAGNOSTICS, our preferred provider for laboratory services when referring members for lab services not covered in the office.

Claims for tests performed at non-par labs without prior authorization will be denied. Medically necessary laboratory services ordered by a PCP or other care provider performed at Quest typically DO NOT require prior authorization (except as noted on our prior authorization list.)

In-Office Labs
Molina allows only certain laboratory tests in the physician’s office. All other medically necessary laboratory testing must be directed to an in-network Laboratory such as Quest Diagnostics by the ordering physician (i.e.: specimens dropped in the Quest box for pick-up). For a list of approved in-office laboratory tests, including tests such as Rapid Strep, visit the “Forms” link above, and click on “In-Office Tests List”.

Claims for lab tests performed in the physician office, but NOT on Molina’s list of allowed in-office or otherwise authorized, may be denied payment.

For the latest list of patient services centers (draw sites), please reach out to Quest Diagnostics or view Molina’s Online Provider Directory.

Quest Diagnostics
866-MYQUEST (866-697-8378)
www.questdiagnostics.com

New Vendor Update

Please be advised that effective July 1, 2019, Molina Healthcare of Florida is starting a new partnership with Health Network One, Inc. (HN1)/American Therapy Administrators of Florida (ATA-FL) and Coastal Care Services.


For DME, Home Health and Home Infusion services, Molina Healthcare’s new exclusive partner will be: Coastal Care Services.

Authorization Requests:

  • MMA, Marketplace, and Medicare:

    • Coastal - All services under will require authorization and you will be required to follow Coastal’s Prior Authorization process.

  • Long-Term Care/Comprehensive (MMA & LTC):

    • Molina - You will continue to follow Molina’s Prior Authorization process.

      Coastal Care Services
      Toll-Free: 1-855-481-0505
      Web: www.ccsicare.com
      Monday – Friday 8:30AM – 5:00PM

      For more information on services not covered by Coastal Care Services, please click here.


      For Free-Standing Therapy services (Physical, Occupational, and Speech), Molina Healthcare’s new exclusive partner will be: Health Network One (HN1)/American Therapy Administrators of Florida (ATA-FL).

      *Please Note: This therapy transition is only delegated for therapies in Free-Standing facilities. Molina is still responsible for therapies in a hospital outpatient or inpatient setting.

      Authorization Requests:

      • MMA, Marketplace, and Medicare:

        • HN1/ATA-FL - All services will require authorization and you will be required to follow HN1/ATA-FL’s Prior Authorization process.

      • Long-Term Care/Comprehensive (MMA & LTC):

        • Molina - You will continue to follow Molina’s Prior Authorization process.

      Health Network One/American Therapy Administrators
      Toll-Free: 1-888-550-8800
      Web: www.ataflorida.com
      Monday - Friday 830AM – 5:00PM

    For more information on Molina Healthcare’s vendor transition, please contact Molina’s Provider Services Department at 1-855-322-4076 for any questions or concerns.

    Thank you for your assistance and cooperation.

      Reminder: Molina is GOING GREEN as of July 1st and all claims need to be submitted through an EDI Clearinghouse or via Molina's Provider Portal. Please contact our Provider Services team if you have any questions.​​

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      Free Online CME Credits!!

      Primary Care Providers - To Earn Extra CME Credits - Click Here

      Important Reminder:

      It is important to Molina Healthcare and your patients that your provider directory demographics are accurate. Please visit our Provider Online Directory at: providersearch.molinahealthcare.com to validate your information and notify us if there are any updates.

      Please notify Molina Healthcare at least 30 days in advance when you have any of the following:

      • Change in office location,
           office hours, phone, fax, or email
      • Addition or closure of office location
      • ​Addition or termination of a
           provider
      • Change in Tax ID and/or NPI
      • Open or close your practice to new
           patients (PCPs only)
      Check Member Eligibility & Benefits button

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      Molina’s Provider Self Services has a variety of tools to simplify your transactions whether you need to check eligibility or check claim status. For more information contact Provider Services. Molina Healthcare is now collecting National Provider IDs (NPIs) from contracted and non-contracted providers. Submit your NPI to Molina via our Provider Self-Services Portal.

      LTSS Quick Reference Guide

      Looking for information about requesting authorization or submitting a claim for Long-Term Services and Supports?.