News and Updates

As a network provider, we are committed to communicating updates and information with you. Through Provider Memos and supplemental e-updates, we will share news with you about our health plan, new opportunities to engage with us, and policy updates.

To receive regular email updates, click the link below:


 

If you have questions, please contact your Provider Network Manager.

Molina Healthcare of Illinois COVID-19 Provider Frequently Asked Questions


Provider Memos

2020 Provider Memos

October 29, 2020 - Policy Reminder: CBHS Care Guidelines for Children in Psychiatric Crisis

October 26, 2020 - Coronavirus Response: Extension of Modified PA Process

October 19, 2020 - 2020 Provider Satisfaction Survey Still Open for Responses

October 15, 2020 - Policy on Care Plan Deviations for HCBS Members

October 13, 2020 - Coming in January: Surgical Procedures Appropriate for an Ambulatory Surgery Center

October 12, 2020 - Help Remind Medicaid Members to Update Their Address Information

October 9, 2020 - Continuity of Care and Billing During Transition Period: Medicaid

October 6, 2020 - New Molina PA Lookup Tool—Set to Go Live on November 2, 2020

October 6, 2020 - Pharmacy Prior Authorizations: Correct Procedure Reminder

October 2, 2020 - New Provider Portal Launch Postponed

October 1, 2020 - Molina’s Transportation Service Vendor Has Changed to MTM as of October 1, 2020

September 30, 2020 - Electronic Data Connectivity (EDC) With Molina Healthcare

September 28, 2020 - Mandatory Model of Care (MOC) Attestation Due November 30, 2020

September 24, 2020 - Q4 2020 Updates to Molina’s Prior Authorization (PA) Requirements

September 23, 2020 - Molina Announces New Provider Portal Coming in October

September 23, 2020 - Understanding New Prepayment Claims Review With Optum

September 17, 2020 - OTP Billing Reminder: Only CMS-Registered Providers Will Be Reimbursed

September 14, 2020 - Consolidating Two Email Boxes Into the Provider Network Management Email Address

September 11, 2020 - Detailed Transportation Billing Guidelines Update

September 9, 2020 - Details About Molina's New Transportation Services Vendor, MTM (beginning October 1, 2020)

September 8, 2020 - Update to IAMHP Roster Location Service Options for Telehealth Services

August 28, 2020 - ORP Claim Validation Requirements

August 28, 2020 - ORP Claim Validation Begins Again

August 28, 2020 - Communicate Via Your IAMHP Roster That You Offer Telehealth Services

August 27, 2020 - Flu Vaccinations are Critical During the COVID-19 Pandemic

August 26, 2020 - Reminder of Waiver Billing Guidelines Effective January 1, 2020


August 24, 2020 - Bureau of Managed Care Policy/Procedure Regarding Patient Credit File/Patient Liability

August 1, 2020 - Molina's Transportation Service Vendor to Change on October 1, 2020

July 30, 2020 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements


June 19, 2020 - Update Regarding our 2020 Quality Incentive Program

June 17, 2020 - New 2020 Bonuses for Providers who help Members with Certain Behavioral Health Concerns

June 12, 2020 - COVID-19 CDC Safety Guidelines

June 12, 2020 - Update and Reminder: New Prepayment Claims Review

June 8, 2020 - Hospital Professional Billing Transition to Outpatient Institutional Claim Format

May 28, 2020 - Provider Notification: Itemized Bill Claim Review

May 27, 2020 COVID-19 HEDIS 2020 Guide for Providers

May 27,2020 The Molina Behavioral Health C.O.V.I.D Screener for Primary Care

May 27,2020 The Psychological Impact of COVID-19 at-a-glance reference

May 12, 2020 - Coordinated Behavioral Health Services (CBHS) Memo

May 7, 2020 - Updated HFS Complaint Tracking Process

April 30, 2020 - Value Code 80 and 81 Accommodation Revenue Code Requirements

April 27, 2020 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

April 14, 2020 - Medicaid Billing: Noncovered Diagnosis Codes

April 2, 2020 - COVID-19 Telehealth/Telepsych Expansion

March 19, 2020 - Molina Healthcare issues Update to Prior Authorizations Process due to Coronavirus

March 18, 2020 - Coding of Evaluation and Management Services

March 5, 2020 - Molina Healthcare Update on Coronavirus

February 19, 2020 - 2020 Quality Incentive Program Now Available

February 14, 2020 - Continuity of Care Reminder

January 31, 2020 - Value Code Requirements

January 29, 2020 - New Pregnancy and Baby Provider Toolkit Available

January 28, 2020 - eviCore New Prior Authorization Requirements Effective January 1, 2020

January 28, 2020 - Ordering, Referring, Prescribing, Attending Provider - National Provider Identifier (NPI) Requirements Reminder

January 28, 2020 - Reminder Ambulance Billing Effective January 1, 2020

January 27, 2020 - Import Updates to Molina Healthcare of Illinois Prior Authorization Requirements

January 27, 2020 - Taxonomy Requirements

January 16, 2020 - Illinois Transportation Billing Guidelines for Managed Care Processing and Payment

January 6, 2020 - Correction to January 1, 2020 Prior Authorization Codification List

details 2019 Archive Provider Memos

December 24, 2019 - Waiver Service Authorizations Reminder

December 23, 2019 - Ambulance Billing Frequently Asked Questions

December 23, 2019 - Changes to Claim Submission Process for All Elective/Emergent Abortion Procedures

December 2, 2019 - Updated HFS Complaint Tracking Process

November 22, 2019 - Single Preferred Drug List Effective January 1, 2020

November 21, 2019 - Waiver Billing Guidelines

November 18, 2019 - Ambulance Billing Effective January 1, 2020

November 14, 2019 - New Prior Authorization Requirments through eviCore

November 5, 2019 - Prohibition on Billing Medicaid Plan Members

October 29, 2019 - Reminder: Electronic Claim, Claim Appeals/Dispute Submission

October 17, 2019 - Ordering, Referring, Prescribing - National Provider Identifier (NPI) Requirements: Postponed

September 30, 2019 - Claims Submission Reminder

September 30, 2019 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

September 25, 2019 - Ambulance Billing Effective January 1, 2020

September 25, 2019 - New Prepayment Claims Review: Postponed

September 24, 2019 - Adult and Child BMI Provider Information

September 11, 2019 - Postponed Implementation Date for New Prior Authorization Requirements through eviCore

September 3, 2019 - Required Model of Care Training

September 3, 2019 - Important Information Regarding Vaccines for Children

August 26, 2019 - Ordering, Referring, Prescribing - National Provider Identifier (NPI) Requirements Reminder

August 20, 2019 - CMHC Claim and Line Roll Up Requirements

August 20, 2019 - Organ Transplant Authorization Reminder

July 19, 2019 - New Prior Authorization Requirements through eviCore

July 16, 2019 - CMHC Subspecialties

July 12, 2019 - Important Information Regarding Dual Eligible Beneficiaries Enrolled in Medicaid Managed Long Term Services and Supports (MLTSS)

July 10, 2019 - New Prepayment Claims Review

July 9, 2019 - Breast Cancer Screening (BCS) Provider Information

July 8, 2019 - New Sections: IAMHP Comprehensive Billing Manual

July 2, 2019 - Claim Management for Member Match Requirement

July 1, 2019 - Reminder: Provider Claims Appeals and Disputes Submission Process

June 28, 2019 - Reminder: Inpatient Psychiatric Billing

June 21, 2019 - New Phone/Fax Numbers for NICU Prior Authorization

June 20, 2019 - New Medicaid and Duals Preauthorization Requirements through eviCore

June 18, 2019 - Important Reminder: Claims Submission

June 18, 2019 - Behavioral Health Excellence Program

June 17, 2019 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

June 14, 2019 - Provider Claims Appeals and Disputes Submission Process

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

May 7, 2019 - Prior Authorization Removal for Provider Types 28, 33, 38 and 39

May 1, 2019 - Illinois Transportation Billing Guidelines for Managed Care Processing and Payment

May 1, 2019 - Ophthalmologist and Optometrist Billing Guidelines

May 2, 2019 - Prior Authorization for Rehabilitation Services

April 15, 2019 - Reminder: Submission of Provider Roster Updates

April 15, 2019 - Reminder: Universal IAMHP Roster Required May 1, 2019

April 15, 2019 - Updated Molina Policy Regarding Reconsideration and Peer to Peer Review

April 9, 2019 - Telehealth Billing Guidelines

April 8, 2019 - Outpatient Rate Update for Critical and Non-Critical Access Hospitals

April 8, 2019 - Updated Molina Policy Regarding Behavioral Health Inpatient Stays

April 3, 2019 - Molina Provider Network Management Email Address

April 2, 2019 - Update Molina Policy Regarding Mental Health Inpatient Stays

April 1, 2019 - Behavioral Health IATP Claims Memo

March 26, 2019 - Provider Online Directory Demographic Updates

March 26, 2019 - Important Update to Molina Healthcare of Illinois Prior Authorization Requirements

March 20, 2019 - 2019 Quality Incentive Program and HEDIS Coding Booklet is now available

March 6, 2019 - Provider CAHPS Tip Sheet Now Available

March 4, 2019 - Molina Partners with Change Healthcare to Implement Coding Advisor Program

March 4, 2019 - IAMHP Comprehensive Billing Manual

February 19, 2019 - Pain Safety Initiative for Medicaid

February 1, 2019 - Primary Care Provider Assignment Reminder

February 1, 2019 - Ordering, Referring, Prescribing - National Provider Identified (NPI) Requirements

February 1, 2019 – Reminder: Dialysis Billing

January 14, 2019 - Practitioner Fee Schedule Update

January 7, 2019 - Reminder: Durable Medical Equipment Claims

details 2018 Archive Provider Memos

December 27, 2018 - New Fax Number and Prior Authorization From for Buy and Bill Medications

December 24, 2018 - New Sepsis Guidelines

December 24, 2018 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

December 18, 2018 - Claim Management for Missing or Incorrect Member Information

December 10, 2018 - Reminder: Provider Roster Template

December 3, 2018 - Community Based Mental Health Services Fee Schedule

November 21, 2018 - HFS Managed Care Billing and Encounter Reporting Guidelines: SUPR Services

November 20, 2018 - Reminder: Illinois Policy Regarding Mental Health Inpatient Stays

November 20, 2018 - Reminder: Third Party Liability

November 13, 2018 - Reminder: Payment Change for Therapeutic Leaves of Absence

November 12, 2018 - Reminder: American Society of Addiction Medicine (ASAM) Guidelines for Substance Abuse Disorders

November 12, 2018 – Community-Based Mental Health Services Fee Schedule Update

November 12, 2018 – Reminder: Authorization Codification Reminder for Providers

November 12, 2018 - Action Required: Provider Roster Template

November 5, 2018 - Reminder: Prenatal Genetic Testing Policy

October 29, 2018 - Reminder: Electronic Claims Submission and Electronic Funds Transfer Options for Providers

October 4, 2018 - New Prescriptions Required for Molina Healthcare of Illinois Members who use Humalog or Novalog

October 1, 2018 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

September 1, 2018 - Molina Healthcare to Launch New Nursing Facility Quality Program

September 1, 2018 - Reminder: Provider Claims Appeals and Disputes Submission Process

July 30, 2018 - Transportation Billing Guidelines for Managed Care Processing and Payment

July 18, 2018 - Reminder for Providers on National Correct Coding Initiative (NCCI)

July 18, 2018 - Corrected Claims Billing Requirements

July 2, 2018 - MCR Providers Must Submit CSPI Results Within 24 Hours

July 1, 2018 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

June 29 2018 - Helpful Tips for Providers Regarding Timely Filing for Claims Submission

June 28, 2018 - Partial Hospitalization Program (PHP) vs Intensive Outpatient Program (IOP) Authorization Requirements

June 11, 2018 - Registration Required for Credentialing for Molina Dual Options Providers

June 5, 2018 - Update to Provider Claims Appeals and Disputes Submission Process

June 4, 2018 - Important Updates to Quality Incentive Program

May 9, 2018 - UB04 xx7 Interim Bill Policy Change

May 7, 2018 – Provider Education Webinar Series Schedule

May 1, 2018 - Important Information Regarding Dual Eligible Beneficiaries Enrolled in Medicaid Managed Long Term Services and Supports (MLTSS)

May 1, 2018 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

April 1, 2018 - 2018 Quality Incentive Program

March 26, 2018 -Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

March 13, 2018 - Molina Hospital Readmission Review

March 13, 2018 - Advanced Imaging Requests - Urgent vs Standard Review Time

March 8, 2018 - Maximum Morphine Equivalent (MME) Dosing Update

February 26, 2018 – Use of Modifier 90 for Outpatient Lab Claims

February 23, 2018 - Prior Authorization Update for Sleep Studies

February 2, 2018 – Molina Healthcare Transportation/Ambulance Denials and Frequently Asked Questions

February 1, 2018 – NICU Claims Processing Change 

January 31, 2018 – Credentialing and Re-Credentialing

January 31, 2018 – Quality Incentive Program

January 31, 2018 – Prior Authorization Times Update

details 2017 Archive Provider Memos

December 8, 2017- Common Value Code Errors for Facility Billing and Encounters

December 1, 2017 – Illinois Prior Authorization Requirements Beginning January 1, 2018

December 1, 2017 – Attention Molina Hospital Providers: CMS Formalized Two Midnight Rule

November 14, 2017 - Molina Helps Protect Members From the Flu

September 29, 2017 - Important Updates to Molina Healthcare of Illinois Prior Authorization Requirements

September 15, 2017 - National Drug Code (NDC) Billing Guidelines

September 1, 2017 - Valid Modifier to Procedure Code Combinations

September 1, 2017 - Corrected Claims Billing Requirements

August 22, 2017 - Molina Healthcare of Illinois to Incorporate American College of Radiology (ACR) Guidelines

August 21, 2017 - Molina Healthcare of Illinois Selected for Statewide Medicaid Contract

August 9, 2017 - Molina Cares Member Rewards Program

July 19, 2017 - Attention Long Term Care Providers: Patient Credit File System Configuration Update

 

July 10, 2017 - Newborn Enrollment Effective Date Guidance

July 1, 2017 - Processing Provider Administered Medications

 

June 6, 2017 - Provider Online Training Courses

May 30, 2017 - Portal System Outage

 

May 22, 2017 - Illinois Transportation Billing Guidelines for Managed Care Processing and Payment

May 20, 2017 - Community Mental Health Centers Billing Guidelines

 

 

 

 

 

 

April 1, 2017 - Molina Healthcare To Implement Electronic Filing Requirement Starting July 1, 2017

details 2015 Archive Provider Memos

December 21, 2015-SASS Providers Must Submit CSPI Results Within 24 Hours

December 17, 2015 - First Quarter 2016 Updates to the Preferred Drug List (PDL)

December 4, 2015 - Pharmacy SNF_ICF_LTC Billing Guidelines

December 2, 2015 - Transportation Memo

October 15, 2015 - Prior Authorization Q2-Q3 Provider Notification Memo

October 9, 2015 - DASA/IMD Billing Guidelines

October 1, 2015 - ICD-10 Provider Memo

October 1, 2015 - ICD-10 Post Implementation FAQs

July 24, 2015 - Medications for Treatment of Hepatitis C

July 13, 2015 - State of Illinois Budget Update

July 13, 2015 - Clinical Practice & Preventive Health Guidelines Update

June 15, 2015 - Updated Pregnancy Notification Form

May 18, 2015 - Reimbursement Rates - No Rate Reductions for Molina Providers

May 1, 2015 - APL Procedure Codes - Billing Requirements

January 5, 2015 - New Prior Authorization Request Form for Behavioral Health Services

January 5, 2015 - Physician Administered Medications Requiring Medical Authorization

details 2014 Archive Provider Memos

details 2013 Archive Provider Memos

Provider Education

details 2018 Archive Provider Education

details 2017 Archive Provider Education

details 2016 Archive Provider Education

 

 

 

 

 

 

details 2015 Archive Provider Education

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Provider Bulletins

details 2017 Archive Provider Bulletins

 

details 2016 Archive Provider Bulletins

 

 

 

details 2015 Archive Provider Bulletin

 

 

 

details 2014 Archive Provider Bulletin