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How to Contact Provider Services at Molina Healthcare of New Mexico

The Provider Services Department has dedicated Provider Service Representatives (PSRs) to assist your office. PSRs are available to offer training, conduct visits to provider offices, help with Provider Portal registration, answer questions and serve as the point of contact for all provider needs.

The below link to the PSR Territory Map reflects the specialty area (Behavioral Health, Long Term Care Support Services and Physical Health), the PSRs and Supervisors responsible for each of these areas and their contact information. Please contact them for any assistance that your office requires. Molina Healthcare Provider Services

How to Join the Molina Provider Network: Access required documents in Frequently Used Forms to facilitate a new contract with Molina Healthcare.

Rendering, Ordering, Attending and Referring Provider Information Required for Molina Healthcare Centennial Care Claims

As a reminder, in accordance with the requirements found in the New Mexico Human Services Department (HSD) Supplements 17-07,17-08 and 17-09 released on Sept. 11, 2017, the appropriate rendering, ordering, attending and referring provider must be billed on claim submissions. Effective for claims with dates of service May 1st , 2018, and after, providers must include the appropriate information regarding the rendering, ordering, attending and referring providers on all claim submissions. If this detailed information is not included in the claim submission, Molina Healthcare will deny Centennial Care claims for dates of service on or after May 1st , 2018. Please refer to the HSD Supplements for the situations which are exempt from this requirement.

For more information about including the appropriate rendering, ordering, attending and/or referring provider information on Molina Healthcare Centennial Care Claims, please refer to the HSD Supplements above or contact your provider network representative at (505) 341-7493 or toll free at 1-855-322-4078.

Health Information Exchange

Molina Health Care of New Mexico, Inc. is pleased to participate with the New Mexico Health Information Collaborative (NMHIC), a secure electronic health care information system that allows participating providers to access patient health care information in real time. The Health Information Exchange (HIE) network is designated through the state to connect unrelated heath care systems and providers to be able to access patient records electronically, securely and privately with the patient’s consent. Providers can access the most up-to-date lab results, medical history and test information to be more prepared when working closely with the patient in making health care decisions.

HIE increases patient safety by having timely access to medication lists, emergency department visits, radiology and laboratory results, as well as facility admission and discharge details to have a more concise and comprehensive patient medical record. Patient health information is shared following federal guidelines in accordance with the Health Insurance Portability and Accountability Act (HIPAA). For more information, visit the New Mexico Health Information Collaborative website at

Provider Services Portal

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Molina’s Provider Self Services has a variety of tools to simplify your transactions whether you need to check eligibility or check claim status. For more information please reference the Web Portal Quick Reference Guide or contact Provider Services. Molina Healthcare is now collecting National Provider IDs (NPIs) from contracted and non-contracted providers. Submit your NPI to Molina via our Provider Self-Services Portal.​

School-based health centers in New Mexico

The New Mexico Alliance for School-Based Health Care represents school-based health centers in New Mexico and collaborates with other partners to promote, facilitate, and advocate for comprehensive, culturally competent health care, including health education, in schools. Click here to learn more about the exciting happenings at School-Based Health Care Centers across the State.

Click here

Hepatitis C Virus Screening and Treatment Survey

Thank you for taking 5 minutes to participate in the Hepatitis C Virus Screening and Treatment Survey.

The New Mexico Human Services Department and the four Medicaid managed care organizations have partnered to conduct this short survey of health care providers on HCV education, screening and treatment.

We truly value your input. By participating in this survey, you make your voice heard and are helping New Mexico reduce morbidity and mortality from hepatitis C. Your responses will help identify gaps and opportunities in HCV education, screening and linkage to care. It will also help us understand the barriers to HCV screening and treatment.

All responses are confidential. The compiled results of the survey will be detailed in a future newsletter.

Thanks again for participating.​​​

Reminder: Molina is GOING GREEN as of July 1st and all claims need to be submitted through an EDI Clearinghouse or via Molina's Provider Portal. Please contact our Provider Services team if you have any questions.

Important Reminder:

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)
New! Medical Equipment and Supplies Update

Molina Healthcare of New Mexico, Inc. is pleased to announce a partnership with Home Medical Equipment Specialists (HME Specialists) for durable medical equipment and home medical supplies state wide. Click here

New! United States Department of Health and Human Services Office of Inspector General (OIG)

The OIG has issued guidance to providers on how to avoid health care fraud and abuse. Click here to review the recommended OIG guidance.​

Overpayment Issue

On February 16, 2012, the Centers for Medicare and Medicaid Services published in the Federal Register its notice of proposed rule-making regarding Providers obligations to report and return Medicaid overpayments to comply with Section 6402 of the Patient Protection and Affordable Care Act (P.L. 111-148). Under the proposed rule, providers, including managed care organization’s contracted providers, are obligated to self-report overpayments within sixty (60) calendar days after such provider has identified (or been notified) of the overpayment. HSD intends to comply with this proposed rule. For more information you may review the proposed rule at 77 Fed. Reg. 9179 et seq.​

ICD10 Implementation Update

Molina Healthcare has fully implemented ICD-10. Have questions? Looking for additional information?Learn more.​

LTSS Quick Reference Guide

Looking for information about requesting authorization or submitting a claim for Long-Term Services and Supports? Learn more.​

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