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Contracted providers are an essential part of delivering quality care to our members. As our partner, assisting you is one of our highest priorities. We look forward to supporting your efforts to provide quality care. If you have questions, call Provider Services at (855) 322-4076 or register below for one of our upcoming educational events:

 

Register below for an upcoming training. Please check back frequently for additional 2024 Provider training opportunities.

 

2024 Upcoming Trainings

 HHAeXchange Webinar: EVV Call Dashboard – Fixing Exceptions

 Wednesday, March 20th  Noon REGISTER
Provider Orientation Presentation Ongoing Self-Guided  VIEW PRESENTATION

 

Laboratory Services

Molina’s providers’ of laboratory services are Quest Diagnostics and Labcorp

Quest Diagnostics                                      LabCorp

866-MYQUEST (866-697-8378)               800-845-6167

www.questdiagnostics.com                    www.labcorp.com

 

Molina allows only specific laboratory tests in the physician’s office. All other medically necessary laboratory testing must be directed to Quest by the ordering physician. 

For a list of approved in-office tests, visit Molina’s website at 
www.molinahealthcare.com

This list includes most tests currently performed in the office by our network providers, and tests generally considered essential (“stat”) for immediate diagnosis and treatment. Claims for tests performed in the physician office, but not on Molina’s list of allowed in-office laboratory tests will be denied.

For more information about In-Network Laboratory Providers, please consult the Molina Provider Directory 
on our website.


For testing available through In-Network Laboratory Providers, or for a list of In-Network Laboratory Provider patient services centers, please reach out to the In-Network Laboratory Provider.

Electronic Medical Records Access

Molina Healthcare strives to improve HEDIS scores year-round through the collection and reporting of data. To achieve high HEDIS scores, the collection of medical records must occur multiple times throughout the year. Molina is interested in strengthening our relationship with provider groups by utilizing EMR Remote Access method to efficiently retrieve the necessary records to meet HEDIS requirements.

Benefits from EMR Remote Access:

  • Reduction in time and office resources
  • Removing the need for multiple outreaches from our team to yours
  • Mitigating COVID-19 risks associated with going on-site

In order to fulfill our state and federal accreditation requirements regarding HEDIS and Risk Adjustment quality reporting, it is necessary for Molina to collect medical record data year-round.

By providing Molina Remote Access to HEDIS data, Molina can simplify the record collection process for the office staff. EMR access ensures Molina receives the required records in a timely manner to properly obtain HEDIS and contract compliance for the selected members.

We are striving for a collaborative relationship; therefore, your Intervention specialist is readily available to offer any help. You can also reach out to a HEDIS Specialist at: RegionDHEDIS@MolinaHealthCare.Com.

Claims Denied for Missing Documentation

Claims denied for missing or additional documentation requirements such as consent forms, invoices, Explanation of Benefits from primary carrier, or itemized bills are not considered claim disputes. In order to process your claim appropriately and promptly, these documents, along with a copy of the claim, must be received within federal and state timely filing requirements and/or your Provider Services Agreement. Please mail the documentation with the copy of the claim to:

Molina Healthcare of FL
P.O. BOX 22812
Long Beach, CA 90801

Please Note: As of January 15, 2020, disputes received for denial reasons stated above will be rejected.

 

     

It is important that your provider directory demographics are accurate. Visit our Provider Online Directory to validate your information and notify us of 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)