Welcome, Michigan Healthcare Providers
Molina Health Plan of Michigan maintains a website as a means to inform, educate, and engage our providers regarding the health plan’s procedures and general operations. Such information includes pre-authorization processes, formularies, periodic fax blasts and our newsletters.
Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.
As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.
If you have any questions, please call Provider Services at (855) 322-4077.
Need a Prior Authorization?
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Join Our Network
At Molina Healthcare, we consider ourselves a part of our member’s extended family. To our extended family, we are committed to providing high quality health care by having a robust network of physicians, hospitals, healthcare facilities, and other healthcare providers.To join our network
Begin the process of joining our network of quality providers by completing a Contract Request Form. We will evaluate your submission and provide you with a response within 5-7 business days for next steps.
Please Note: To be a contracted provider with Molina Healthcare of Michigan, you must have your NPI registered with CHAMPS. (Link to CHAMPS).
For more information about Molina Healthcare and to review our Provider Manual, please visit: https://www.molinahealthcare.com/providers/mi/medicaid/manual/Pages/provd.aspx.
For the current Medicaid fee schedule please visit: https://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_42542_42543_42546_42551-159815--,00.html
Michigan Medicaid Benefits Re-determination (Renewal Process)
The Redetermination process is used for annual reviews to renew your Michigan Medicaid patients’ benefits. The Michigan Department of Health and Human Services (MDHHS) must re-determine an individual’s eligibility for active programs every 12 months.
How can you help your Medicaid patients?
You can help by reminding your Medicaid patients to call MDHHS to ensure their income verification is complete and educate them on the redetermination process. For an extensive list of Redetermination frequently asked questions, please click here.
Molina Healthcare of Michigan Fraud, Waste and Abuse Compliance Notification
Molina Healthcare of Michigan is focused on ensuring that fraud, waste and abuse does not occur. If you believe fraud, waste and abuse has taken place, you can report it without giving your name. You can contact Molina anonymously by:
|Molina Healthcare of Michigan
Attention: Compliance Director
880 West Long Lake Road, Ste. 600
Troy, MI 48098-4504
|Michigan Department of Health and Human Services
Office of Inspector General
P.O. Box 30062
Lansing, MI 48909
Phone: 1-855-MI-FRAUD (1-855-643-7283)
We are here for you!
Do you have questions about enrollment? Would you like to schedule an appointment with your Provider Service Representative?
Let us know how we can help! Please contact us at (855) 322-4077 or click on our link here.
Claims Dispute Request Form
CHAMPS Fax Blast
New Medicaid Dental Benefits for Pregnant Women
Molina Healthcare of Michigan Vendor Transitions - Effective July 1, 2018
Physician Office Laboratory Tests
Primary Care Management of Depression
Behavioral Health Provider Toolkit
Behavioral Health Toolkit for Primary Care Providers
Pregnancy Scheduling Calendars
Provider Change Form
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
- Addition or termination of a
- Change in Tax ID and/or NPI
- Open or close your practice to new
patients (PCPs only)
Find the Provider Change form hereUnder the forms tab.
Nitro or Adobe are required to utilize the Provider Change Form and/or the Provider Addition Roster
Mail: 880 West Long Lake Road Suite 600 Troy MI, 48098
Maternal Infant Health Providers (MIHP)
All Maternal Infant Health Providers (MIHP) should bill Molina Healthcare directly for services. For a list of frequently asked questions please click here.
Thank you for attending our MIHP Webinar. For a copy of the PowerPoint presentation, please click here
For more information about MIHP, visit the following web page: www.michigan.gov/mihp
The Molina Healthcare of Michigan Appeals team coordinates clinical review for Provider Appeals. For more information, please refer to the Provider Appeals and Grievances section in the provider manual. Please click here.
Care for Diverse Populations
To learn more about Care for Diverse Populations click here.