Need a Prior Authorization?
PA Lookup tool is under maintenance.
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Recent Updates
The information below outlines the steps to take so Molina can thoroughly research and advise on the next steps. Molina requests that our providers also share this information directly with their EDI partners:
- Providers should submit an issue ticket with their respective clearinghouse to research and resolve all EDI issues before submitting the issue to Molina.
- For EDI issues that cannot be resolved by the clearinghouse, providers should:
- Send EDI questions to Molina via a secure email to OHProviderRelations@MolinaHealthcare.com.
- All EDI questions must include the following data elements to ensure the most efficient intake and research process: date of service, Molina member's full name, Molina member's ID number, billed amount, Pay To NPI, Rendering Provider NPI, and the Molina Payer ID used for submission of the transactions.
The current PA Code List became effective Oct 1, 2023, view it here.
The Medicaid Provider Manual, effective as of Feb. 1, 2023, is posted here.
The MyCare Ohio Provider Manual with Addendum, effective as of July 1, 2023, is posted here.
Medication Assisted Treatment
Addiction
Basics
Safety
Molina Peer Support Program
Addiction
For more information call (855) 665-4623, TTY/TDD: 711, Monday - Friday from 8:00 a.m. - 8:00 p.m. local time and ask for our Care Management department.
Medicare Compliance Program
Molina Compliance Hotline: (866) 606-3889 or Molinahealthcare.AlertLine.com
Reporting Compliance and Fraud, Waste, or Abuse
Molina Medicare Compliance Program
Code of Business Conduct and Ethics
Medicare Compliance Issues Policy
Document Retention and Destruction Policy
Medicare Fraud, Waste, and Abuse Plan
FDR Compliance Auditing Policy
Your Opinion Matters to Molina
Email us to share your comments, concerns or ideas. Your feedback is important to us. Let us know what we're doing well and what we can do to improve.Through the “It Matters to Molina” program, we have a dedicated Provider Relations Team to intake and resolve your questions or issues and solicit input and feedback from you, our network providers and administrative staff, about ways Molina can improve our technology, tools and processes to minimize administrative hurdles and better support you.