Credentialing & Patient Safety
Molina Healthcare has a duty to protect its members by assuring the care they receive is of the highest quality. One protection is assurance that our providers have been credentialed according to state and federal regulatory requirements and accreditation standards. Your responsibility, as a Molina Healthcare provider includes full disclosure of all issues and timely submission of all credentialing and re-credentialing information.
Molina Healthcare also has a responsibility to its providers to assure the credentialing information it reviews is complete and accurate. As a Molina Healthcare provider, you have the right to:
- Strict confidentiality of all information submitted during the credentialing process;
- Nondiscrimination during the credentialing process;
- Be notified of information obtained during the credentialing process that varies substantially from what is submitted by you;
- Review information submitted to support your credentialing application, with the exception of references, recommendations or other peer-review protected information;
- Correct erroneous information;
- Be informed of the status of your application upon request;
- Receive notification of the credentialing decision within 60 days of the committee decision;
- Receive notification of your rights as a provider to appeal an adverse decision made by the committee; and,
- Be informed of the above rights.
For further details on all your rights as a Molina Healthcare provider, please review your Provider Manual or call your Provider Services Representative for more details.
Patient Safety activities encompass appropriate safety projects and error avoidance for Molina Healthcare members in collaboration with their primary care providers.
Safe Clinical Practice
The Molina Healthcare Patient Safety activities address the following:
- Continued information about safe office practices
- Member education; providing support for members to take an active role to reduce the risk of errors in their own care
- Member education about safe medication practices
- Cultural competency training
- Improve continuity and coordination of care between providers to avoid miscommunication
- Improve continuity and coordination between sites of care such as hospitals and other facilities to assure timely and accurate communication
- Distribute research on proven safe clinical practices
Molina Healthcare also monitors nationally recognized quality ratings for facilities from the following groups:
*Printed copies of information posted on our website are available upon request.