Molinalogo

• Step One - Connect

  Points of contact and the process for joining our network will differ depending on the type of provider that you are. Please follow the instructions below for your provider type:

   

  All Providers of Dental, Vision and Pharmacy

  Please submit a Contract Request on our online provider portal.

  Long Term Support Services (LTSS) including Certified Family Homes

  Florida Medicaid's Long-Term Services & Supports (LTSS) provide essential medical and personal care for individuals needing help with daily activities (bathing, dressing, eating) due to aging, disability, or chronic conditions. For additional information, please visit – Statewide Medicaid Managed Care Long-term Care Program. Please submit a Contract Request on our online provider portal

  Dental Providers

  Molina Healthcare of Florida provides dental services to Medicaid adult and pregnant members through DentaQuest. To become a dental provider, please contact (844) 870-3977 or visit DentaQuest.com. Molina’s Marketplace supplemental dental benefits are administered through our vendor, Delta Dental. For participation, please call (888) 818-7932 or visit DeltaDental.com .

  Vision Providers

  Molina covers both medical and routine vision services. Medical benefits are administered by Molina, while Marketplace and supplemental Medicare benefits are administered through our vendor, Vision Service Plan (VSP). To provide both medical and routine vision services to Molina members, you will need to contract with both Molina and VSP. To contract with VSP, please visit the provider page at VSP.com or by calling (916) 851-4165. Note: Ophthalmology physicians may contract directly through Molina utilizing the Contract Request Form at the top of this page.   Note: Practitioner groups that include optometrists must be contracted with our vendor in order to contract with the Health Plan.

  Pharmacy Providers

  Please contact our Pharmacy benefits manager, CVS Pharmacy, by visiting Join CVS Caremark Network or by calling (800) 364-6331.

   

   

• Step Two - Documentation

  If your Contract Request is accepted, you will be asked to provide additional information in our online provider portal to complete both the contracting and credentialing processes. Provider information and documents you may be asked to provide in the portal may differ depending on provider type, and may include:

  • - Ownership and Control Disclosure Form
  • - W-9
  • - Practitioner Information
  • - Medicaid Identification Number(s)
  • - Molina Roster File

  
  

   

  Upon completion of your online application, Provider Network Management will then begin the network enrollment process and send you a Provider Agreement for signature.

• Step Three - Credentialing

  Credentialing requirements for HDOs

  
  

  All HDOs will need to provide their state license(s) and applicable accreditations and certifications to be credentialed. A site visit may also be required for your facility. Once your request to join the network is accepted, you will be provided login instructions to upload your credentialing documents in the Provider Network Management Portal.

  
  

   

• Step Four - Contract

  The final step will be for Molina to countersign your Provider Agreement and provide you with a signed copy. Credentialed facilities and/or practitioners will also be loaded into Molina’s claims payment system as in-network providers. The in-network effective date for each facility and/or practitioner will be the date of credentialing completion, which will be included in the notification that you will receive from Molina.

Adding practitioners to your existing practice or making changes to your provider information?  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

First time user of our new online provider portal? Please click here to receive a username and password to update your information.

Existing users of our online provider portal: Please click here to access our online provider portal to update your information.

Questions?

For more information about Molina Healthcare, please review the Medicaid and Marketplace Provider Manuals.

For the current Medicaid fee schedule, please visit Rule 59G-4.002, Provider Reimbursement Schedules and Billing Codes | Florida Agency for Health Care Administration..

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