“I love working with Molina, their claim department is responsive and efficient”
Dr. Marina Jones
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Molina Contracting Forms
Contracted providers are an essential part of delivering quality care to our members. Molina Healthcare of Illinois values our provider partnerships and supports the doctor-patient relationship our members share with you.
As our partner, superior customer service and provider relations are one of our highest priorities. We welcome your feedback and look forward to assisting all your efforts to provide quality care.
If you have questions or concerns, please call Molina Healthcare Provider Services at (855) 866-5462.
If you are not currently a Molina Healthcare provider, but are interested in contracting with us, please call Molina Healthcare Provider Services at (855) 866-5462.
You may also complete and submit a Non-Par Provider Contract Request form and email it to MHILProviderNetworkManagement@MolinaHealthcare.com
The provider alerts section contains time-sensitive messages that require your attention.
March 22, 2019 - Provider Alert - Illinois Configuration Issue
April 23, 2019 - Provider Alert - Illinois Configuration Issue: CMS 1500 Claims
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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.
The Molina Heatlhcare Provider Manual includes valuable information about Molina Healthcare and describes how we will work together as you care for your patients' health care needs.
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Reminder: Molina would like to remind you to visit our News & Updates page in order to access the Provider Bulletin and other important updates on prior authorization and billing requirements. To access this page, visit the Communications tab located on the website’s navigation bar and select News & Updates.
We know you’re busy and may not have time to check our website for provider updates. That’s why we’re offering you the opportunity to receive the latest provider news delivered automatically to your inbox. Please sign up for our new provider email list. Just click on this link:
Please notify Molina Healthcare at least 30 days in advance when you have any of the following:
June 20, 2019 - New Medicaid and Duals Preauthorization Requirements through eviCore
June 11, 2019 - Formulary Updates: Third Quarter 2019
May 21, 2019 - MCR Providers Must Submit IM-CAT Results Within 24 Hours
May 16, 2019 - Important Information Regarding Vaccines for Children
May 16, 2019 - Prior Authorization Documentation Reminder
Frequently Used Forms
Q4 Prior Authorization Codification List - 2019
Q3 Prior Authorization Codification List - 2019-
Q2 Prior Authorization Codification List - 2019-
Q1 Prior Authorization Codification List - 2019-
Medical Prior Authorization Request Form- Provider Manual- Pharmacy Prior Authorization Form- Medications for Treatment of Chronic Hepatitis C Prior Authorization Form
- Illinois Hospital Healthcare System Service Area Map - Illinois Service Area - Ancillary