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 except Dental, Vision and Pharmacy

  Please submit a Contract Request on our online provider portal.

  Long-Term Services & Supports (LTSS) Providers

  Long Term Support Service (LTSS) providers are available to eligible MassHealth members to enable them to live with independence and dignity and participate in their communities. Please visit mass.gov/masshealth-ltss-programs-and-services for more information.   If you are one of these providers, please submit a Contract Request on our online provider portal.

  Dental Providers

  Molina Healthcare of Massachusetts provides dental services to members through DentaQuest. To become a dental provider, please contact (844) 870-3977 or visit DentaQuest.com.

  Vision Providers

  Molina Healthcare of Massachusetts provides vision services through VSP. To contract with VSP, please visit the provider page at VSP.com or by calling (916) 851-4165.   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 receive login credentials to the online portal to provide additional information 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 or Organization credentialing Information
  • - Medicaid Identification Number(s)
  • - Molina Roster File (the preferred roster template will be available in the online portal after you receive your login credentials)

  
  

   

  Find these documents on our Frequently Used Forms page. 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

  Providers must meet credentialing requirements.
  Credentialing requirements for Practitioners
  For provider types that require credentialing, please ensure that you have a complete CAQH application. This means:

  • - Your application status is complete
  • - You have authorized Molina to view your data
  • - You have attested in the last 120 days
  • - All your documents are completed and have not expired

   

  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?  Login to the Provider Network Management portal to add a practitioner or upload a roster.

• 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.

Are you a contracted provider and need to make 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
• Termination of a provider
• Change in Tax ID and/or NPI
• Open or close your practice to new patients

Questions?
For more information about Molina Healthcare, please review the  Provider Manual. If you have any questions, please call Provider Services at (855) 838-7999 or SWHProviderRelations@molinahealthcare.com