Payment Integrity Policies
Molina Healthcare of Illinois (Molina) has revised and formalized its existing Payment Integrity and Recovery Program in alignment with state and national coding practices. Molina’s renewed mission is to identify and correct improper payments through the efficient detection and collection of overpayments, and the identification of underpayments to providers regarding claims. This enables Molina to implement actions and system improvements that will ensure correct payments in the future.
The following concepts provide transparency so providers can easily see definitions and source documentation for each one. Click below for details on each concept. Updates will be added here as new concepts are identified.