Need a Prior Authorization?
Recent Updates
ODM News:
EDI (Electronic Data Interchange) Inquiries: Per the Ohio Department of Medicaid (ODM), trading partners should direct all EDI questions and concerns through the Ohio Medicaid Enterprise System (OMES) EDI Help Desk at OMESEDIsupport@Medicaid.ohio.gov or by calling (800) 686-1516.
IMPORTANT UPDATE: Per ODM, terminations resumed on Jan. 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management (PNM) module. If you are currently due for a revalidation in the PNM module, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. Find additional information on the ODM PNM & Centralized Credentialing page, under the "Important update: Terminations to resume effective January 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management module" header.
Molina News:
The Prior Authorization (PA) Code Updates by line of business, effective Oct. 1, 2024, are posted here under the “Prior Authorization Code Changes” header. Please utilize the PA Code LookUp Tool to search for codes that require PA.
The Medicaid Provider Manual, effective as of Jan. 1, 2024, is posted here.
The MyCare Ohio Provider Manual, effective as of Jan. 1, 2024, is posted here.
Medication Assisted Treatment
Molina Peer Support Program
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
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Molina Healthcare of Ohio's "You Matter to Molina" program prioritizes connecting directly with our network of over 90,000 providers and supporting their efforts to deliver high-quality and efficient health care for Molina members.
Through the “You Matter 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.