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 with the Exception of LTSS, Dental, Vision and Pharmacy

  Please submit a Contract Request on our online provider portal.

  Long Term Support Services (LTSS) Providers

  NY’s Medicaid Long-Term Services & Supports (LTSS) provide essential medical and personal care for individuals needing help with daily activities (bathing, dressing, eating) due to aging, disability, or chronic conditions. For additional information, please visit NYDOH’s Managed Long Term Care (MLTC). Please submit a Contract Request on our online provider portal.

  Dental Providers

  Molina Healthcare provides dental services to Medicaid adult and pregnant members through Liberty Dental®. To become a dental provider, please contact Liberty Dental® at (866) 609-1184 (TTY:711)

  Vision Providers

  Molina covers both medical and routine vision services. Medical benefits are administered by Molina, while supplemental benefits are administered through our vendor, Vision Service Plan (VSP). To provide both medical and routine vision services to Molina members, you will need to contract with both Molina and VSP. To contract with VSP, please visit the provider page at VSP.com or by calling (916) 851-4165. Note: Ophthalmology physicians may contract directly through Molina. Please submit a Contract Request on our online provider portal. Note: Practitioner groups that include optometrists must be contracted with our vendor 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 be asked to provide additional information in our online provider portal 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:

  
  

  • - W-9
  • - Practitioner or Organization credentialing Information
  • - Medicaid Identification Number(s)
  • - Disclosure of Ownership
  • - Molina Roster File (the preferred roster template will be available in the online portal after you receive your login credentials)

  
  

   

  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 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.

Are you a contracted Provider with Molina Healthcare and need to add 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.

Adding practitioners to your existing practice or making 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
• Addition or termination of a provider
• Change in Tax ID and/or NPI
• Open or close your practice to new patients

Providers should submit their change requests to mhnynetworkoperations@molinahealthcare.com.

Questions?

For more information about Molina Healthcare, please review the Provider Manuals available online.

If you have any questions, please call Provider Services at (855) 322-4077.