Contact Information

Member Eligibility Verification (800) 223-7242
Member Services  (800) 223-7242
Provider Services (877) 872-4716
Utilization Management (877) 872-4716
Main Fax (844) 879-4509
UM Fax (866) 879-4742
For a full list of provider contact information, please reference the Provider Quick Reference Guide.

CVS/Caremark – Pharmacy
Prior Auths, Inquiries: (877) 872-4716 
Retail Drugs only: (800) 364-6331
Fax: (844) 823-5479
DentaQuest – Dental Services
Telephone: (888) 308-2508  
Fax: (262) 241-7379 
Claims/Payment issues: (262) 241-7379 
All other: (262) 834-3589
Mailing Address:
DentaQuest IPA of New York LLC -                                   
ATTN: Claims or UM/Appeals (same address for both)           
PO Box 2906                                                             
Milwaukee, WI 53201-2906

Superior Vision / Versant Health –Vision Services

Telephone: (866) 819-4298

PAYER ID: 41352 
Mailing Addresses:
Complaints and Appeals Department
PO Box 791
Latham, NY 12110

Paper Claims
ATTN: Claims Department
PO BOX 967
Rancho Cordova, CA 95670

The Claims Department is located at our corporate office in Long Beach, CA. All hard copy (CMS-1500, UB-04) claims must be submitted by mail to the address listed below. Electronically filed claims must use EDI Claims/Payor ID number - 16146. To verify the status of your claims, please call our Provider Claims Representatives at the numbers listed below.

Address Molina Healthcare of New York, Inc.
PO BOX 22615
Long Beach, CA 90801
Phone: (877) 872-4716


For more information, refer to the Provider Manual.

Claim Disputes/Reconsiderations
Providers disputing a Claim previously adjudicated must request such action within 90 days of Molina’s original remittance advice date. Regardless of type of denial/dispute (service denied, incorrect payment, administrative, etc.); all written Claim disputes must be submitted on the Molina Provider Appeal Form found on Provider website and the Provider Portal. The form must be filled out completely in order to be processed.
Additionally, the item(s) being resubmitted should be clearly marked as a Claim Payment Dispute and must include the following:
  • Any documentation to support the adjustment.
  • The Claim number clearly marked on all supporting documents
  • Copy of Authorization form (if applicable) must accompany the reconsideration request.
Submission Process:
  • Provider Portal:
  • Fax: 315-234-9812
  • Mail: Molina Healthcare of New York, Inc.
    Attention: Appeals and Grievances Department
    1776 Eastchester Road | Bronx NY, 10461