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We want to share some important information regarding Molina Healthcare’s Centennial Care health plan and your contract with Molina to service Members.
Molina Healthcare of New Mexico, Inc. was not selected to provide Medicaid services beginning January 1, 2019.
Presbyterian Health Plan and Blue Cross Community Centennial will continue to be Managed Care Organizations (MCOs) and Western Sky Community Care will be a new MCO contracted with the State to provide services starting January 1, 2019.
While Molina Healthcare of New Mexico, Inc. was not selected to provide Medicaid services beginning January 1, 2019, Molina Healthcare will remain in New Mexico and will continue to participate in the Marketplace. We will provide service and support for this line of business to both our Members and Providers.
Molina Healthcare’s offices and contact numbers will continue to operate normally for Centennial Care business and our employees remain committed to serving you and our Members. We will also continue to meet the terms of our Centennial Care contract with the state of New Mexico, including working with provider partners on value-based agreements, cost-sharing opportunities and quality interventions.
Molina Healthcare will meet all regulatory requirements regarding notification to the State of New Mexico Human Services Department (HSD) of terminated providers for Centennial Care through regular communication as needed.
Molina Healthcare will also continue to provide support to you and answer questions you have relative to Centennial Care in a “business as usual” format through August 31, 2019.
After January 1, 2019, you will continue to be supported by Molina Healthcare for Claims with service dates on or before Dec. 31, 2018.
|120 Calendar Days
||90 Calendar Days
||210 Calendar Days
||730 Calendar Days|
|From date of service to submit original claims.
||From the adjudicated date for claim reconsiderations, disputes, appeals and questions.
||From the date of service for claims that have third-party liability or are Medicare crossover claims.
||From the date of service for I/T/Us to submit any claim.|
Claim Submission: Electronic Data Interchange (EDI) Payer ID: 09824
Portal at: https://provider.molinahealthcare.com/
P.O. Box 22801
Long Beach, CA 90801
Contact Information during transition
Check status of claims and prior authorizations on the self service Provider Portal at: https://provider.molinahealthcare.com/
Provider Services Support Center: (855) 322-4078
Provider Services Fax number: (505) 798-7313
Please submit all claim research and inquires to the following email boxes:
These boxes are checked throughout normal business hours and we will be able to address any issues in a timely manner as has been our standard practice.
What does this mean for Members?
- They will continue to receive health care services and prescription drug coverage with Molina Healthcare through December 31, 2018. The benefits and services listed in the Member Handbook will be available through that date.
- They should have received a letter from HSD in a turquoise envelope around October 1, 2018. It informed them of the changes and what they need to do chose another Centennial Care MCO for January 1, 2019. If they have not received this letter they can contact HSD toll free at (888) 997-2583 or visit the HSD website at http://www.hsd.state.nm.us/centennial-care-2-0.aspx.
- Molina Healthcare will work to make sure there is a smooth transition for Members to their new MCO with no gaps in care. We will also be transferring medical records, authorizations, and other information to their new MCO.
- If they have services approved by Molina Healthcare scheduled after December 31, 2018, their new MCO will honor those approved services for up to 60 days after January 1, 2019.
We are proud to have served New Mexico’s Medicaid population for over 20 years and value your partnering with us to provide quality healthcare.