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Provider Bulletin

The Provider Bulletin is published for Molina Healthcare participating providers in Ohio to communicate updates about medical management policies and procedures.

Provider Bulletins Going Green – We’re moving to paperless distribution. If you receive the Provider Bulletin via mail, click here to give us your email address to ensure you keep getting important updates.

*The links below are in PDF format ( pdf icon )

 

2019 Month
Provider Bulletin – Special Edition: Medicare & New PA Code List October 2019
Provider Bulletin: It Matters to Molina Corner, Medicare Inpatient Rate Updates, Contact Provider Services, Anesthesia Services Modifiers, Quality Living Awardees, PA Requirements for UDS, Model of Care Training, Americans with Disabilities Act, Provider Satisfaction Survey, Reconsideration Requirements, Provider Training, BH Q&A Sessions, Changes to PA Code List, Changes to Provider Manual, Did you know? October 2019
Provider Bulletin – Special Edition: Smoking Cessation and Lead Initiatives September 2019
Provider Bulletin – Special Edition Behavioral Health: Model of Care Training, PA Requirements for UDS, BH Provider Manual Updates, BH Timely Claim Submission, Advances Recoupment Process, BH Contingency Funds, Enrollment and Credentialing, Narcan Nasal Administration, Billing in the Provider Portal, Rendering Providers, BH Q&A Session, Provider Portal Training, Non-Licensed Provider Status, Active Medicaid ID Number, Billable Service Codes, Provider Support, Behavioral Health FAQ September 2019
Provider Bulletin – Special Edition: eviCore Update September 2019
Provider Bulletin: It Matters to Molina Corner, Model of Care Training, Sepsis Payment Policy Update, Provider Satisfaction Survey, BH Provider Manual Updates, Reconsideration Requirements, Corrected Claims for Primary EOB, Medication-Assisted Treatment, Electronic Visit Verification, Update: Drug Rebate Agreement, Provider Training, BH Q&A Sessions, Changes to PA Code List, Changes to Provider Manual, Did you know?, DUR Program September 2019
Provider Bulletin – Special Edition: Patient Driven Payment Model August 2019
Provider Bulletin – Special Edition: Outpatient Hospital Behavioral Health August 2019
Provider Bulletin – Special Edition: Pregnancy Risk Assessment Form August 2019
Provider Bulletin – Special Edition: Nursing Facility August 2019
Provider Bulletin – Special Edition: Model of Care August 2019
Provider Bulletin – Special Edition: eviCore August 2019
Provider Bulletin: It Matters to Molina Corner, Provider Satisfaction Survey, Balance Billing, Reconsideration Requirements, Provider Newsletter, Corrected Claims for Primary EOB, Medication-Assisted Treatment, Electronic Visit Verification, Provider Training, BH Q&A Sessions, Changes to PA Code List, Changes to Provider Manual, Did you know?, DUR Program, Update: Drug Rebate Agreement August 2019
Provider Bulletin – Special Edition: EVV July 2019
Provider Bulletin – Special Edition: Authorization Reconsideration July 2019
Provider Bulletin – Special Edition Behavioral Health: BH Timely Claim Submission, BH Contingency Funds, BH Provider Manual Updates, BH Q&A Session, Provider Portal Training, Enrollment and Credentialing, Narcan Nasal Administration, Billing in the Provider Portal, ERA and EFT, Opioid Education Resources, PA for New Services, BH Redesign & Integration, Enrollment Updates, Rendering Providers, Non-Licensed Provider Status, Active Medicaid ID Number, Psychological Testing Codes, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Provider Support, Behavioral Health FAQ July 2019
Provider Bulletin: It Matters to Molina Corner, DUR Program, CRRF Requirements, Paper Claims CRRF, Member Match Requirements, Updated Drug Formulary, Update: Drug Rebate Agreement, Quality of Living Awardees, Molina Provider Portal, Electronic Visit Verification, Provider Training, BH Q&A Sessions, Changes to PA Code List, Changes to Provider Manual, Medication-Assisted Treatment, Corrected Claims for Primary EOB, Hepatitis A Vaccine, CAQH Provider Demographic July 2019
Quality Provider Bulletin: Cervical Cancer Screenings, Submit BMI Assessments with ICD-10 Codes, Molina Team Graduates from IHI Course, Coding Tips for Pregnancy Related Services, Safety Guidelines from Ohio Minds Matter June 2019
Provider Bulletin – Special Edition: Hospice Room and Board June 2019
Provider Bulletin – Special Edition Behavioral Health: BH Contingency Funds, BH Provider Manual Updates, BH Q&A Session, Provider Portal Training, Enrollment and Credentialing, Narcan Nasal Administration, Billing in the Provider Portal, ERA and EFT, Opioid Education Resources, PA for New Services, BH Redesign & Integration, Enrollment Updates, Rendering Providers, Non-Licensed Provider Status, Active Medicaid ID Number, Psychological Testing Codes, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Provider Support, Behavioral Health FAQ June 2019
Provider Bulletin: Hepatitis A Vaccine, Electronic Visit Verification, Alzheimer’s Association Training, Reconsideration Form, CAQH Provider Demographic, Multiple Procedure Payment Reduction on Advance Imaging, All-Cause Readmissions, Provider Training, BH Q&A Sessions, BH Correct Claims Training, Changes to PA Code List, Notice for IMDs, Hospital Based Clinic Visit June 2019
Provider Bulletin – Special Edition Behavioral Health: BH Provider Manual Updates, BH Q&A Session, Corrected Claims Training, Provider Portal Training, Enrollment and Credentialing, Narcan Nasal Administration, Billing in the Provider Portal, ERA and EFT, Top Denials with Remit Codes, Opioid Education Resources, PA for New Services, BH Redesign & Integration, Enrollment Updates, Rendering Providers, Non-Licensed Provider Status, Active Medicaid ID Number, Psychological Testing Codes, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Provider Support, Behavioral Health FAQ May 2019
Provider Bulletin:CAQH Provider Demographic, Reconsideration Form Requirements, Multiple Procedure Payment Reduction on Advance Imaging, Electronic Visit Verification, Alzheimer’s Association Training, All-Cause Readmissions, Hospital Based Clinic Visit, Provider Training, Changes to PA Code List, 2019 HEDIS® Data Collection, Notice for IMDs May 2019
Provider Bulletin – Special Edition: Waiver April 2019
Provider Bulletin – Special Edition: Hepatitis A Vaccine April 2019
Provider Bulletin – Special Edition: EVV April 2019
Provider Bulletin – Special Edition: MAT April 2019
Provider Bulletin – Special Edition Behavioral Health: Enrollment and Credentialing, Corrected Claims Training, Provider Portal Training, Narcan Nasal Administration, Billing in the Provider Portal, ERA and EFT, Top Denials with Remit Codes, Opioid Education Resources, Psychological Testing Codes, PA for New Services, Provider Support, BH Redesign & Integration, Enrollment Updates, Rendering Providers, Non-Licensed Provider Status, Active Medicaid ID Number, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Behavioral Health FAQ April 2019
Provider Bulletin: All-Cause Readmissions, Notice for IMDs, 2019 HEDIS® Data Collection, Quality of Living Awareness, Hospital Based Clinical Visit, Authorization & Claim Reconsideration Process Update, Provider Demographic Updates, PA Requirements for Non-Par Providers, Provider Training, Did You Know, Changes to PA Code List, Access Standards April 2019
Quality Provider Bulletin: Molina Reimburses PCP In-Office Retinal Screenings, In-Home Blood Pressure Program, PRAF 2.0 Electronic Submission, CAVS Member Incentive Program March 2019​
Provider Bulletin – Special Edition Behavioral Health: Provider Demographic Update, Narcan Nasal Administration, BH Redesign & Integration, Psychological Testing Codes, Holding Claims, New File Size for Submissions, Common Billing Errors, Provider Portal Training, Billing in the Provider Portal, ERA and EFT, Non-Licensed Provider Status, Top Denials with Remit Codes, Active Medicaid ID Number, Provider Support, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, PA for New Services, Behavioral Health FAQ March 2019
Provider Bulletin: 2019 HEDIS® Data Collection, Hospital Based Clinic Visit Facility Fees, MyCare Ohio Newborn Coverage, SACWIS Newborn Coverage, Authorization & Claim Reconsideration Process Update, Standard Authorization Form, Provider Demographic Updates, PA Requirements for Non-Par Providers, NDC Billing Guidelines, Changes to PA Code List, Provider Training, Americans with Disabilities Act, Cultural & Linguistic Competency, New File Size for Submissions March 2019
Provider Bulletin – Special Edition: Waiver February 2019
Provider Bulletin – Special Edition Behavioral Health: BH Redesign & Integration, Psychological Testing Codes, Top Denials with Remit Codes, Active Medicaid ID Number, Holding Claims, New File Size for Submissions, Common Billing Errors, Provider Portal Training, Billing in the Provider Portal, ERA and EFT, Non-Licensed Provider Status, Provider Support, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, PA for New Services, Behavioral Health FAQ February 2019
Provider Bulletin: Molina Holding Claims, LARC Payment, ASD Code Updates, New File Size for Submissions, Medicaid ID, NDC Billing Guidelines, Holding Claims, Did You Know, Changes to PA Code List, Provider Training February 2019
Provider Bulletin – Special Edition: Sepsis and Septic Shock Payment Policy January 2019
Provider Bulletin – Special Edition Behavioral Health: BH Redesign & Integration, Psychological Testing Codes, Top Denials with Remit Codes, Active Medicaid ID Number, Holding Claims, New File Size for Submissions, Common Billing Errors, Provider Portal Training, Billing in the Provider Portal, ERA and EFT, Non-Licensed Provider Status, Provider Support, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, PA for New Services, Behavioral Health FAQ January 2019
Provider Bulletin: Medicaid Unified PDL, New File Size for Submissions, PA – Urgent vs. Non-Urgent, NF Ventilator Program Update, Medicaid ID, NDC Billing Guidelines, ODM BH Redesign, Did You Know, Changes to PA Code List, Provider Training, Holding Claims January 2019
2018 Month
Provider Bulletin – Special Edition: Waiver Signature Requirements December 2018
Provider Bulletin – Special Edition: Holiday December 2018
Provider Bulletin – Special Edition: Authorization & Reconsideration December 2018
Provider Bulletin – Special Edition Behavioral Health: Active Medicaid ID Number, 2018 Open Enrollment, Third Party Biller Functionality, Common Billing Errors, Provider Portal Training, Corrected Claims, Billing in the Provider Portal, ERA and EFT, Enrollment Update, Non-Licensed Provider Status, Provider Support, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, PA for New Services, Behavioral Health FAQ December 2018
Provider Bulletin: Medicaid ID, Preferred Drug List, Waiver Signature Requirement, Holding Claims, 2018 Open Enrollment, Medicare Reimbursement, Home Health Fax Numbers, NDC Billing Guidelines, ODM BH Redesign, Sterilization, Hysterectomy and Abortion Consent Forms, Did You Know, Changes to PA Code List, Provider Training, Molina Partners with Cavs, Provider Portal Poll, Skilled Therapy, Corrected Claims, Updated PIF Form, Outpatient Therapy Caps December 2018
Provider Bulletin – Special Edition: COAAA November 2018
Provider Bulletin – Special Edition: COAAA F​ollow Up November 2018
Quality Provider Bulletin: CPT II Codes for Blood Pressure Results, November is National Diabetes Awareness Month, Prenatal Risk Assessment Form, Well Child Visits, Molina Partners with Cleveland Cavaliers on New Member Incentive Program November 2018
Provider Bulletin – Special Edition: Unified PDL November 2018
Provider Bulletin – Special Edition: Public Comment November 2018
Provider Bulletin – Special Edition Behavioral Health: BH Provider Form, 2018 Open Enrollment, Third Party Biller Functionality, Common Billing Errors, BH Q&A WebEx Training, Provider Portal Training, Corrected Claims, Billing in the Provider Portal, ERA and EFT, Active Medicaid ID Number, Enrollment Update, Non-Licensed Provider Status, Provider Support, Billable Service Codes, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, PA for New Services, Behavioral Health FAQ November 2018
Provider Bulletin: 2018 Open Enrollment, Medicare Reimbursement – SNF, Home Health Fax Numbers, Transportation Billing, NDC Billing Guidelines, Third Party Biller Functionality, 2018/2019 Flu Season, ODM BH Redesign, Sterilization, Hysterectomy and Abortion Consent Forms, Did You Know, Changes to PA Code List, Provider Training, Provider Portal Poll, Skilled Therapy, Corrected Claims, Updated PIF Form, Outpatient Therapy Caps November 2018
Provider Bulletin – Special Edition Behavioral Health: Claims Payment Systematic Error, BH Provider Form, Common Billing Errors, BH Q&A WebEx Training, Provider Portal Training, Corrected Claims, Billing in the Provider Portal, ERA and EFT, Active Medicaid ID Number, Non-Licensed Provider Status, Provider Support, Billable Service Codes, Enrollment Update, Identifying a Molina Member, Member Eligibility, Rendering Providers, Opioid Education Resources, FFS Prior Authorizations, PA for New Services, Behavioral Health FAQ October 2018
Provider Bulletin – Special Edition: Cultural Competency October 2018
Provider Bulletin: Updated PIF Form, Post-Acute Provider Intake Form, Healthchek Reminder, Tobacco Cessation, Care Coordination Visit Guide, Molina and Cavs Partnership, Rendering Provider NPI, BH Carve-In for PCP Providers, ODM BH Redesign, Sterilization, Hysterectomy and Abortion, Consent Forms, Did You Know, Changes to PA Code List, Provider Training, Updated In-Office Lab Testing, Corrected Claims, Outpatient Therapy Caps October 2018
Quality Provider Bulletin: In-Home Blood Pressure Program, Total Diabetes Care Program, Behavioral Health Redesign, Tips on Improving the Use of Multiple Concurrent Antipsychotics, Coding Tips for Pregnancy Related Services, ICD-10-CM Diagnosis Coding, HEDIS Tips Booklet Minor Misprint, Wellness Measure Tips September 2018
Provider Bulletin – Special Edition: OBGYN September 2018
Provider Bulletin – Special Edition Behavioral Health: Corrected claims, Billing in the Provider Portal, Provider Portal Status for Non-Licensed Provider Records, Rendering Provider NPI, Upcoming Molina BH Q&A WebEx Training Sessions, Upcoming Provider Portal WebEx Training Sessions, Provider Data Validation, ERA and EFT for Providers, Active FFS Prior Authorizations, Member Eligibility, Common Billing Errors that Cause Claims to Deny, Active Medicaid ID Number, Provider Support Available, Service Codes Billable to Medicare and Third Party Liability, Enrollment Updates for BH Agencies, Identifying a Molina Healthcare Member, Rendering Providers in Provider Portal, New Opioid Education Resources, Requesting Prior Authorization for New Services Behavioral Health – Frequently Asked Questions September 2018
Provider Bulletin: Updated Drug Formulary, Molina Announces Partnership with Cleveland Cavaliers, Medical Foods, Americans with Disabilities Act, Cultural Competency, Updated In-Office Laboratory Testing List, Sterilization, Hysterectomy and Abortion Consent Forms, Nursing Facility Care Coordination Visit Guide, Rendering Provider NPI, Behavioral Health Carve-In for Primary Care Providers, ODM Behavioral Health (BH) Redesign, Notice of Changes to Prior Authorization (PA) Requirements, Outpatient EAPG Services, Corrected Claims, Provider Training Sessions, Outpatient Therapy Caps, Fighting Fraud, Waste & Abuse September 2018
Provider Bulletin – Special Edition Behavioral Health: Billing in the Provider Portal, Provider Portal Status for Non-Licensed Provider Records, Rendering Provider NPI, Upcoming Molina BH Q&A WebEx Training Sessions, Upcoming Provider Portal WebEx Training Sessions, Provider Data Validation, ERA and EFT for Providers, Active FFS Prior Authorizations, Member Eligibility, Common Billing Errors that Cause Claims to Deny, Behavioral Health – Frequently Asked Questions, Active Medicaid ID Number, Provider Support Available, Service Codes Billable to Medicare and Third Party Liability, Enrollment Updates for BH Agencies, Identifying a Molina Healthcare Member, Rendering Providers in Provider Portal, New Opioid Education Resources, Requesting Prior Authorization for New Services August 2018
Provider Bulletin – Special Edition: EVV August 2018
Provider Bulletin: Licensed Practical Nurses (LPN) Renewal 2018, Complex Claim Review Process, Model of Care Training, Sterilization, Hysterectomy and Abortion Consent Forms, Molina Healthcare Quality Living Program Awardees, Inpatient Admission and Review, Nursing Facility Care Coordination Visit Guide, Rendering Provider NPI, Behavioral Health Carve-In Information for Primary Care Providers, Behavioral Health Member Eligibility Assistance, ODM Behavioral Health (BH) Redesign, Did You Know?, Notice of Changes to Prior Authorization (PA) Requirements, Top Claim Denials, Outpatient EAPG Services, Provider Newsletter, Updated – Corrected Claims, Updated In-Office Laboratory Testing List, Provider Training Sessions, Non-Par Laboratory Testing PA, Outpatient Therapy Caps, Fighting Fraud, Waste & Abuse August 2018
Provider Bulletin – Special Edition Behavioral Health: Active FFS Prior Authorizations, Upcoming Behavioral Health Sessions, Upcoming Face to Face Orientations, Behavioral Health Carve-In Information for All Providers, Rendering Provider NPI, Service Codes Billable to Medicare and Third Party Liability, Member Eligibility, ERA and EFT for Providers, Common Billing Errors that Cause Claims to Deny, Behavioral Health Redesign Claims Testing, Active Medicaid ID Number, Provider Support Available, Enrollment Updates for BH Agencies, Identifying a Molina Healthcare Member, Behavioral Health – Frequently Asked Questions, Rendering Providers in Provider Portal, BH Rendering Testing Guidance, New Opioid Education Resources, Requesting Prior Authorization for New Services, Claims Features Training July 2018
Provider Bulletin - Special Edition: Model of Care July 2018
Provider Bulletin - New Nursing Facility Guide, Active Medicaid ID Number, BH Carve in for PCPs, Rendering Provider NPI, BH Independence - OH Training, BH Springdale - OH Training, ODM BH Redesign, BH Member Eligibility Assistance, Medicaid Redetermination, Changes to PA Code List, Corrected Claims, In-Office Laboratory Test List, Provider Training, Non-Par Laboratory Testing PA, DME Q&A Session, Outpatient Therapy Caps July 2018
Provider Bulletin – Special Edition: New Nursing Facility Guide June 2018
Provider Bulletin – Special Edition Behavioral Health: Molina BH WebEx Training, Independence Ohio Training, Identifying a Molina Member, Behavioral Health FAQ, Rendering Providers, BH Claims Testing, Common Billing Errors, Provider Support, Enrollment Update, BH Testing Guidance, Opioid Education Resources, PA for New Services, Claims Features Training June 2018
Quality Provider Bulletin: Pregnancy Rewards Changes, Changes to Passport to Perks Incentive Program, Proper Blood Pressure Readings, HbA1c In-Office Testing, 7-Day Follow Up After Hospitalization for Mental Illness (FUH) Measure June 2018
Provider Bulletin: Nursing Facility Room & Board, In-Office Laboratory Test List, Medicaid Redetermination, New NPI Requirements, Medicaid Check Runs, Outpatient Therapy Caps, Enrollment Application, Corrected Claims, ODM BH Redesign, FQHC Transportation, Provider Training, DME Q&A Sessions, Online Claim Reconsiderations, NDC Billing Guidelines, Non-Par Laboratory Testing PA June 2018
Provider Bulletin – Special Edition: FQHC Transportation Reimbursement May 2018
Provider Bulletin – Special Edition: Behavioral Health Redesign May 2018
Provider Bulletin: Outpatient Therapy Caps, DME Q&A Sessions, Enrollment Application, Pregnancy Rewards, Provider Satisfaction Survey, Corrected Claims, ODM BH Redesign, Change to PA Code List, Provider Training, Cures Act MAT Training, Online Claim Reconsiderations, NDC Billing Guidelines, Physician Laboratory Tests, Non-Par Laboratory Testing PA May 2018
Provider Bulletin – Special Edition: Medicaid Restricted Coverage Periods April 2018
Provider Bulletin – Special Edition: Behavioral Health Redesign April 2018
Provider Bulletin: Provider Satisfaction Survey, Quality Living Program Awardees, Concurrent & Post Payment Denials, Corrected Claims, 2018 HEDIS® Data Collection, Cures Act MAT Training, Provider Training, ODM BH Redesign, Partners in Care, Americans with Disabilities Act, Physician Laboratory Tests, Non-Par Laboratory Testing PA, Online Claim Reconsideration, NDC Billing Guidelines April 2018
Provider Bulletin – Special Edition: Waiver Services March 2018
Provider Bulletin – Special Edition: Behavioral Health Redesign March 2018
Provider Bulletin: Corrected Claims, Provider Training, Physician Laboratory Tests, 2018 HEDIS® Data Collection, Cures Act MAT Training, ODM BH Redesign, Facility Claims, Cultural Competency, Access Standards, Non-Par Laboratory Testing PA, NDC Billing Guidelines, Online Claim Reconsideration March 2018
Quality Provider Bulletin: Provider Incentive for Prenatal Care, Postpartum Care Coding Tips, Retinopathy Screenings, BH Redesign, Antipsychotics in Children and Adolescents February 2018
Provider Bulletin – Special Edition: Behavioral Health Redesign February 2018
Provider Bulletin: 2018 HEDIS® Data Collection, Cures Act MAT Training, BMI Reporting, Postpartum Care Coding Tips, ODM BH Redesign, Physician Laboratory Tests, Non-Par Laboratory Testing PA, NDC Billing Guidelines, Online Claim Reconsideration February 2018
Provider Bulletin – Special Edition: Behavioral Health Redesign January 2018
Provider Bulletin: Laboratory Testing, Non-Par Laboratory Testing, ODM Behavioral Health, National Drug Code, Updated PA Code List, Online Claim Reconsideration January 2018
2017 Month
Holiday Provider Bulletin: Happy Holidays from Molina! December 2017
Provider Bulletin – Special Edition: Behavioral Health Redesign December 2017
Provider Bulletin: Corrected Claims, ODM Behavioral Health, NDC Billing Guides, New Transportation Vendor, Office Laboratory Tests, New PA Code List, Mailing Information, Evaluation & Management, Fee-for-time Compensation, Online Claim Reconsideration December 2017
Quality Provider Bulletin: Timely Prenatal Care, National Diabetes Awareness Month, HEDIS® Measure Spotlight: Follow-Up After Hospitalization for Mental Illness December 2017
Provider Bulletin – Special Edition: Behavioral Health Redesign Claims Testing November 2017
Provider Bulletin – Special Edition: Medicaid Enrollment ID Requirements November 2017
Provider Bulletin: Updating PIF Form, PA Code Addition Update, BH Redesign 501 Trainings, ODM BH Redesign, Claim Adjustment Reason Codes, Reconsideration Process, NDC Billing Guidelines, DME Modifiers, Prior Authorization Reminder, Partners in Care Newsletter, Americans with Disabilities Act, Online Claim Reconsideration November 2017
Provider Bulletin – Special Edition: Cultural Competency October 2017
Provider Bulletin: 2017 Open Enrollment, Online Claim Reconsideration, Medicaid Renewal Deadline, Prescription Opioids, Milliman MCG Tool, ODM BH Redesign, New Hospice Rates, Healthchek Reminder, Nursing Facility Communications, New Provider Orientation, HNCC Dissolving October 2017
Dental Bulletin – Special Edition: Link to Scion Provider Web Portal with Payer ID Number September 2017
Dental Bulletin – Special Edition: Link to Scion Provider Web Portal September 2017
Provider Bulletin – Special Edition: Ownership and Control Disclosure Form Requirement September 2017
Provider Bulletin – Special Edition: Molina Healthcare EAPG Update September 2017
Provider Bulletin – Special Edition: Orthodontic Continuation of Care September 2017
Provider Bulletin – Special Edition: Grandfathered Medication List September 2017
Provider Bulletin: Claim Reconsideration Requests, Cleveland Clinic, Waiver Authorizations, All- Cause Readmission, Transportation Claims, Encounter Requirements, Care Management Program, NDC Billing Guidelines, Compound Drugs, New Provider Orientation, New PA Code List, Observation Billing, Clear CoverageTM Update, NOC Billing Guidelines, HealthInHand App, Prior Authorization Form, ACR Guidelines Added September 2017
Provider Bulletin – Special Edition: Learn new skills and earn CME credit August 2017
Provider Bulletin – Special Edition: Mandatory Model of Care Training August 2017
Provider Bulletin: Prior Authorization Form, NDC Billing Guidelines, ACR Guidelines Added, HNCC Dissolving Program, Claim Reconsideration Form, Behavioral Health Respite Care, EDI Companion Guides, Milliman’s MCG Tool, EAPG Payment Methodology, Transportation Claims, Accident Billing Claims, Clear Coverage Update, Interpreter Services, Pregnancy Check-Up, Evaluation and Management, Diabetes Provider Toolkit, Submitting EDI Claims, BH Redesign, Out Patient BH Redesign Codes August 2017
Provider Bulletin: Dental Updates, Insect Repellent Prescriptions, Pregnancy Risk Assessment, BH Redesign, Submitting EDI Claims, Comprehensive Perinatal Care, Provider Manual Update, Hospital Rates Update, Care Plan Coordination, Uniform Authorization Form, EAPG Payment Methodology, Milliman’s MCG Tool, Co-Surgery Services July 2017
Provider Bulletin – Special Edition: Portal System Back Online June 2017
Provider Bulletin: BH Redesign, Submitting EDI Claims, 30-Day Readmission, Partners in Care Newsletter, Opioid Drug Abuse, Comprehensive Perinatal Care, New PA Code List, Milliman MCG, EAPG Payment Methodology, Claim Adjudication and Payment, Refunds, Provider Appeals, LARC Device Reimbursements, ODA Shared Living, Children with Autism June 2017
Provider Bulletin – Special Edition: Portal System Outage May 2017
Quality Provider Bulletin: Healthy Members through HEDIS® and CAHPS®, Prenatal and Postpartum Care, How Well Doctors Communicate, Our Commitment to Support Quality Perinatal Care, Member Motivation - Pregnancy Rewards, Early Identification - PRAF Form, Postpartum Visit Notification, Changes to the Seven-day FUH - Follow Up After Hospitalization, Lab in an Envelope Home Screening Program, Passport to Perks, CAHPS® Survey Administration May 2017
Provider Bulletin: Submitting EDI Claims, Behavioral Health Redesign, Covered & Non-Covered Days, CAHPS® Survey, Encounter Requirements, Basic Billing Training, NOC Billing Requirements, Updated PA Request Form, POS Coding for Scion, Health Care Coding Tips, COB & TPL Billing Guidelines, EAPG Payment Methodology, Americans with Disabilities Act, Cultural & Linguistic Competency, Corrected Claims, No CRRF May 2017
Provider Bulletin – Special Edition: Place of Service (POS) Coding for Scion April 2017
Provider Bulletin: CAHPS® and HSAG Survey, CPC Program, Hospice Rates, Child Birth Codes, Behavioral Health Redesign, Submitting EDI Claims, Provider Satisfaction Matters, Newborn Claims Billing, Access Standards, Changing NPI in MITS, New Billing for Hospice & NF April 2017
Quality Provider Bulletin: CAHPS and HSAG Survey Administration, Rating of Personal Doctor, How Well Doctors Communicate, Getting Needed Care, Health Promotion and Education, Shared Decision Making March 2017
Provider Bulletin: Submitting EDI Claims, Encounter Requirements, Aide Nursing Rate Changes, Home Health CPT Code Retired, Ownership Disclosure, Long Term Support Services, NF Ventilator Program, New Prior Authorization (PA) List March 2017
Provider Bulletin: Update to Medicare PA Processing, Billing Guidelines for FQHCs, Complex Claim Review Process, Clear Coverage, NOC Billing Requirements, Behavioral Health Redesign, Claim Reconsideration Update February 2017
2016 Month
Provider Bulletin: New Populations Joining Molina, Transportation Changes, Pharmacy Benefit Changes, Dental Benefit Changes, Behavioral Health Redesign, Expedited Appeals, Eff. Feb 1, 2017 – New PA List, Earn $50 for Prenatal Care, Flu Season Tips, Clear Coverage December 2016
Provider Bulletin – Special Edition: CPAP Therapy Changes for Durable Medical Equipment (DME) Providers December 2016
Provider Bulletin – Special Edition: Happy Holidays from Molina, Pharmacy Benefit Changes, Prevention Claim Denial – EPSDT, Updating Your Provider Information, Claim Reconsideration Requests Update December 2016
Provider Bulletin – Special Edition: Changes to the Dental Benefits are Coming Effective Jan. 1, 2017, Scion Dental Web Portal, Electronic Funds Transfer (EFT) November 2016
Quality Provider Bulletin: Partners in Care Newsletter Online, Healthy Members through HEDIS®, Satisfied Members through CAHPS® November 2016
Provider Bulletin: Inpatient Stays for Behavioral Health, MedXM Providing Health Assessments to Members, New Populations Joining Molina Healthcare, ODM Behavioral Health Redesign, Transportation Changes, Mandatory Cultural Competency Training November 2016
Provider Bulletin: Claim Reconsideration Requests Update, Transplant and NICU Fax Number Changes, Home Health CPT Code Retired – G0154, Vaccines for Children Billing and Reimbursement Update, Remind Patients About Healthchek and Children in Custody, Adoption Joining Molina Healthcare October 2016
Provider Bulletin – Special Edition: Pregnancy Rewards, Earn $50 for Timely Prenatal Care October 2016
Provider Bulletin: Outpatient and Inpatient Payment, Pre-Release Pilot for Justice-Involved Members, Panel Limitations Reminder for Primary Care Providers, Earn $50 for Timely Prenatal Care, Prescriptions for Insect Repellent Now Covered, Corrected Claims Submission Tips, Provide Preventive Care During Other Types of Care September 2016
Quality Provider Bulletin: Important Note About Member ID Cards, Earn $50 for Timely Prenatal Care, Healthy Members through HEDIS, Satisfied Members through CAHPS, Access and Availability of Care August 2016
Provider Bulletin: Episode-Based Payment Model Reports, Transportation Claim Modifiers, Home Health Claim Modifiers, Evaluation and Management Billing Guidelines, Claims Processing, Member Level of Care Changes, Access Standards August 2016
Provider Bulletin: PCP Assignment and Changes, Billing MMP Enrollees for Medicare Cost-Sharing Prohibited, Corrected Claims or EOBs from the Primary Insurance, ODM Behavioral Health Redesign , Annual Mandatory SNP Model of Care Training July 2016
Provider Bulletin: Dual Coverage Dental Eligibility, Referring to Network Providers, Nursing Facility Transportation, Behavioral Health Redesign, NDC Requirement, Partners in Care Newsletter, Health Care Coding Tips, Provider Satisfaction Survey June 2016
Quality Provider Bulletin: Molina Healthcare’s Commitment to Healthy Members and Quality Services May 2016
Provider Bulletin: Inpatient/Outpatient PA Requests, Encounter Requirements, Delivery Claims, Recipient of NCQA Award, Revalidation Requirement, Behavioral Health Redesign, Walk-in Retail Clinics, Health Care Coding Tips May 2016
Provider Bulletin – Special Edition: Dental COC April 2016
Provider Bulletin: Inpatient Authorization Requests, Prior Authorization Update, Hospice Billing Information, Corrected Claims Requirements, Delivery Claims Update, Updating Provider Information, Faster Claim Reconsideration, SBIRT in Primary Care, New ODM Fee Schedule Codes April 2016
Provider Bulletin - Special Edition: Patient Liability Claims Correction March 2016
Quality Provider Bulletin: Molina Healthcare’s Commitment to Healthy Members and Quality Services March 2016
Provider Bulletin: Waiver Services Authorizations, Patient Liability Errors, POA Requirements, Federal Revalidation Requirement, Reminder About Diabetic Patients, Disability Discrimination Prohibited, Cultural & Linguistic Competency, Supporting CD4AP, Hospice Nursing Services Codes, Reaching a Care Manager March 2016
Provider Bulletin - Special Edition: OB/GYN Progesterone Therapy Update February 2016
Provider Bulletin - Special Edition: Skilled Nursing Facilities Submitting Service Dates for Room and Board February 2016
Provider Bulletin: Billing Members Prohibited, Network Participation Status, Behavioral Health TOC, Independent Provider Overtime, Clear Coverage Training, Updating Provider Information, Changes for Delivery Claims February 2016
Provider Bulletin – Special Edition: Online Orientations for New Dental Program January 2016
Provider Bulletin: Medicare Part B Cost Sharing, MyCare Ohio Crossover Claims, Prevent Claim Rejection, Psychotropic Drugs for Children, Reaching a Care Manager, Make the Most of Flu Season, Pharmacy PDL Update, Clear Coverage Training, New ODM Sterilization Form January 2016
2015 Month
Provider Bulletin: New PA List and Form, Nurse & Aide Rate Changes, Home Health Codes for Medicare, Expanded NDC Requirements, Prevent Claim Denial – EPSDT, Prevent Claim Rejection December 2015
Holiday Provider Bulletin: Happy Holidays from Molina, Prevent Claim Denial – EPSDT, Updating Provider Information, Clear Coverage Training December 2015
Quality Provider Bulletin: Molina Healthcare’s Commitment to Healthy Members and Quality Services Fall 2015
Provider Bulletin: Prevent Claim Denial – EPSDT, ICD-10 Claims Based on Date, Upcoming PA Code List Update, Fall Partners in Care Newsletter, NDC Requirements Expanding, Assigning Members a PCP, Revalidation Requirement, Clear Coverage Corner, Mandatory SNP Training November 2015
Provider Bulletin – Special Edition: Transition to Secure Tr​ansportation October 2015
Provider Bulletin: Prevent EPSDT Claim Denial, Claim Rejection: Spanned Dates, PA Reconsideration vs. Appeal, Progesterone Therapy Fax, Clear Coverage Corner, New Transportation Vendor, Patient Liability Reconciliation, Web Portal Support Desk, Updating Provider Information, Return of Overpayment Form, ICD-10 Update October 2015
Provider Bulletin: Prevent EPSDT Claim Denial, Immunization Status, Home Health Billing Guidelines, PA Reconsideration vs. Appeal, Clear Coverage Corner, Corrected Claim Requirements, Healthchek, Refer to Participating Providers, Easier-to-Read EOPs, Web Portal Support Desk, Prospective Records Review, ICD-10 Update September 2015
Provider Bulletin – Special Edition: Preparing for ICD-10 August 2015
Quality Provider Bulletin: Molina Healthcare's Commitment to Healthy Members and Quality Services Summer 2015
Provider Bulletin: Prevent EPSDT Claim Rejection, Explanation of Payments Update, Leadership Staff Update, Immunization Status, Resources for Skilled Nursing Facilities, Clear Coverage Corner – Training, Reconsideration vs. Appeal, Provider Portal Support Desk, ICD-10 Update August 2015
Provider Bulletin – Special Edition: EPSDT Billing Guidelines July 2015
Provider Bulletin: EPSDT Billing Guidelines, MinuteClinic Joins Provider Network, Clear Coverage Corner – Training, Immunization Status, Only Commendable Medicaid Health Plan in Ohio, Provider Satisfaction Matters, Provider Portal Support Service Desk, Primary Care Provider Payment, Important Notice to MyCare Ohio Providers, ICD-10 Update July 2015
Provider Bulletin: Notice for Providers Serving MyCare Ohio Members, Patients’ Medicaid Renewal Deadline, Text4baby – Free Texts for Moms, Clear Coverage Corner – Enhancements, Patients to Receive Updated ID Cards, Molina Healthcare Achieves NCQA Commendable, Mandatory Waiver Provider Training, Correct Claims Submission, Pre-Authorization Denials, Care Management – How You Can Help, ICD-10 Update June 2015
Provider Bulletin – Special Edition: MyCare Ohio Transportation May 2015
Quality Provider Bulletin: Molina Healthcare's Commitment to Healthy Members and Quality Services Spring 2015
Provider Bulletin: Primary Care Rate Increase Payments, Notice for Providers Serving MyCare Ohio Members, Corrected Claims Submission, Introduction to Care Management, Updated Billing Guidelines Coming Soon, Patients’ Medicaid Renewal Deadline, Clear Coverage Corner – Training, Primary Insurance Information, Claim Reconsideration Requests, Hospice Room and Board Update, ICD-10 Update May 2015
Provider Bulletin: Patients’ Medicaid Renewal Deadline, Update to Corrected Claims Process, Clear Coverage – Training Sessions, Access Standards, ICD-10 Implementation Update, Claim Reconsideration Policy Update April 2015
Provider Bulletin: Patient’s Medicaid Renewal Deadline, Clear Coverage Corner – Automatic Approval, ICD-10 Implementation Update, Depression in Primary Care, Telemedicine, MyCare Ohio Web Portal Update March 2015
Provider Bulletin: Clear Coverage Corner – Accessibility, Service Code Authorization Groups, Upcoming Provider Training Webinars, ICD-10 Implementation Update, Telemedicine, MyCare Ohio Passive Enrollment Split Billing, MyCare Ohio EFT for Waiver Providers, Molina MyCare Ohio Regional Forums Febraury 2015
Provider Bulletin: Preferred Drug List, Electronic Funds Transfers, Ohio Medicaid APR DRG Requirement, ICD-10 Implementation Update, 2015 MyCare Ohio Transportation, Provider Training Webinars Janurary 2015
2014 Month
Provider Bulletin: Amended PA Requirements, APR DRG Requirement, ICD-10 Implementation, Emdeon Processing, MyCare Ohio Passive Enrollment, NET Transportation, Partners in Care Newsletter December 2014
Quality Provider Bulletin: Comprehensive Diabetes Care, Antidepressant Medication Management,  Follow-up After Hospitalization For Mental Illness, Initiation/Engagement of Alcohol and Drug Dependence Treatment, Follow-up For Children Prescribed Attention Deficit Hyperactivity of Disorder (ADHD) Medication,  Frequency of Ongoing Prenatal Care & Timeliness of Prenatal Care, Postpartum Care (PPC), Getting Care Quickly Fall 2014
Provider Bulletin: Amended Par Requirements – Jan. 1, 2015, Pharmacy Facts, Provider Spotlight, Secure Messaging with  Care Managers November 2014
Provider Bulletin: 2014 Prospective Medical Record Review & Retroactive Risk adjustment, Provider EMR Access, Fall Prevention, ICD-10 Implementation Update, Ebola Resources October 2014
Provider Bulletin: All Patient Refined Diagnosis Groups, 2014 Prospective Medical Record Review & Retroactive Risk Adjustment, ICD-10 Implementation Update, Electronic Funds Transfer, Long-term Services and Supports (LTSS) Claims Submission Trainings, Upcoming MyCare Ohio Provider Forums September 2014
Provider Bulletin: Emailing PHI Security, Delegation of Children With Special Health Care Needs (CSHCN), Prior Authorization, Provider Engagement Team Meetings, Corrected Claims Submission August 2014
Quality Provider Bulletin: Molina Healthcare's Commitment to Healthy Members and Quality Services Summer 2014
Provider Bulletin: Pharmacy Facts, Healthchek, Navigating the Coordinating Services Program, Documenting BMI Assessments July 2014
Provider Bulletin: Submitting Corrected Claims, Pharmacy Facts, Solvaldi, Provider Information Updates, Dual Options Behavioral Health Update, Partners in Care Provider Newsletter Posted on the Web, Provider Satisfaction Matters to Molina June 2014
Provider Bulletin: Pharmacy Facts, PA No Longer Required for Mirena, Webex Online Trainings, Multiple Therapy Reduction, ICD-10 Update May 2014
Provider Bulletin - Special Edition: Molina Dual Options MyCare Ohio Provider Orientation April 2014
Provider Bulletin: Update to Pre-Service & Post-Service Claim Reconsideration Policy, Pharmacy Facts, Access Standards- Helping Members Set Reasonable Expectations, Public Website Home Page Improvements, What is MyCare Ohio, When Will MyCare Ohio Begin, How Will This Impact Your Patients, Website Roundup, April's Quality Check, Webex Online Trainings, Repeat & Reminders, Provider Spotlight, Fighting Fraud, Waste and Abuse, Molina Healthcare Contacts, April Community Outreach Events, Webex Online Trainings, Team Approach to Care Coordination, Combined Benefit Package, MyCare Ohio Quick Links April 2014
Quality Provider Bulletin: Molina Healthcare's Commitment to Healthy Members and Quality Services Spring 2014
Provider Bulletin: MyCare Ohio Update, New HEDIS® Scorecard Web Portal Tool, Pharmacy Facts, CMS-1500 Claim Form, Healthy Members & Quality Services, What's New at Molina, Website Roundup, Outpatient PA Request March 2014
Provider Bulletin - Special Edition: Revised CMS 1500 claim form v02/12 March 2014
Provider Bulletin: Molina's Clear Coverage Offers Automatic Authorization and Real Time Responses, Amended Prior Authorization Requirements Effective Jan. 1, 2014, Phase-Out of High-Dose Prescription Acetaminophen Combination Products, 2014 HEDIS Data Collection, Provider Web Portal Updates, Respite Care Benefit, CMS Communication: ICD-10 Provider Survey, Members’ Satisfaction with Health Promotion and Education, Commitment to Healthy Members and Quality Services February 2014
Provider Bulletin: Molina Healthcare Provider Website Updates, Clear Coverage Monthly Online Training Sessions, Respite Care Benefit , Billing Requirements, Reimbursement, Delegation of Children with Special Health Care Needs, Vision Problems Can Cause Falls Among Older Ohioans, Commitment to Healthy Members and Quality Services, Members’ Satisfaction with Shared Decision Making January 2014​
2013 Month
Provider Bulletin - Special Edition: Compliance Reminder: HIPAA 5010 Attending Provider Billing Requirements, Accountable Care Act (ACA) Primary Care Payment Increase December 2013​
Provider Bulletin: Amended Prior Authorization Requirements effective Jan. 1, 2014, Clear Coverage Monthly Online Training Sessions, Enrollment Department Fax Number, Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, Cultural & Linguistic Competency, Claim Reconsideration Request Form (CRRF), Corrected Claims, Members’ Satisfaction with Getting Care and Doctor Communication, Commitment to Healthy Members and Quality Services December 2013​
Provider Bulletin: Flu Vaccines 2013-2014, The Assist Group, 2014 Prior Authorization Guide, Clear Coverage Monthly Online Training Sessions, The Americans with Disabilities Act, Partners in Care Provider Newsletter Posted, Commitment to Healthy Members and Quality Services ​November 2013
Provider Bulletin: Covering Ohio: Health Insurance Marketplace, New Provider Services Line and Standardized IVR System, Improved Molina Healthcare Website Goes Live, Claim Reconsideration Request Form (CRRF), Vaccinate Your Patients to Prevent the Flu, Emailing Protected Health Information (PHI) Securely, Free Treatment Supplies from the Ohio Amblyope Registry, Accessing Care for Members with Disabilities, Fall 2013 Preschool Vision Screening Training, The Importance of Body Mass Index (BMI) Assessments, Inpatient Policy Changes Effective Oct. 1, 2013, Commitment to Healthy Members and Quality Services, Clear Coverage Monthly Online Training Sessions, Members’ Satisfaction with Personal Doctor and Specialist, Fighting Fraud, Waste and Abuse  ​October 2013
Provider Bulletin: Molina Healthcare of Ohio is Moving, Claim Reconsideration Request Form Fax Number Change, New Standardized IVR System, Inpatient Policy Changes Effective Oct. 1, 2013, Inpatient Policy Changes Effective Oct. 1, 2013, Electronic Funds Transfer & Remittance Advice, All Patient Refined Diagnosis Groups (APR-DRGs), Clear Coverage Implementation, Ohio Department of Medicaid Communication, Help Us Help Our Members, Cervical Cancer Screening & HEDIS®, Commitment to Healthy Members and Quality Services, 2013 Prospective Medical Record Review (PMRR) ​September 2013
Provider Bulletin - Special Edition: Non-Contracted Provider Mailing ​August 2013
Provider Bulletin: Transition of Care (TOC) for Members Transitioning from Ohio Medicaid Fee-For-Service (FFS)
or Exiting Managed Care Plans (MCP) Amerigroup and WellCare to Molina Healthcare of Ohio, 2013 Primary Care Physician Rate Increase, Appeal Process on Behalf of a Member, Pain Management Procedure 2013 Service Request Guidelines, New Inpatient Policy Changes Effective Oct. 1, 2013, Monthly Online Training Sessions, Members’ Satisfaction with All Health Care, Commitment to Healthy Members and Quality Services
August 2013​
Provider Bulletin: Delegation of Children with Special Health Care Needs, Integrated Care Delivery System Go-Live Date, OAC: MCP Primary Payer, Monthly Online Training Sessions, Update to Pre-Service and Post-Service Claim Reconsideration Policy July 2013
Provider Bulletin: Molina Healthcare Invites Physicians to Participate in Clinical Committees, Monthly Online Training Sessions, Auto-Approval for Prior Authorizations System Now Live, Update to Pre-Service and Post-Service Claim Reconsideration Policy, Nominate a Community Champion Today, Register for the Molina Healthcare Web Portal and Win Prizes, Health Insurance Marketplace, Partners in Care Provider Newsletter Posted, Reminder: Advanced Imagining Unit to Review Prior Authorization/Service Requests June 2013
Provider Bulletin: Enrollment Period Information, Payment for Preventive Services, Making Changes to Prior Authorizations, Molina Healthcare of Ohio Regional Orientations, Endometrial Ablation Procedures, Access Standards – Helping Members Set Reasonable Expectations, Commitment to Healthy Members and Quality Services, Members’ Satisfaction with All Health Care May 2013
Provider Bulletin: Children with Special Health Care Needs, Important Enrollment Period Information, Strep Test Policy Change, Help Us Help Our Members, Advanced Imaging Unit, Preschool Vision Testing, Commitment to Healthy Members and Quality Services, Important Reminders, Fighting Fraud, Waste and Abuse, Join our Email Distribution List and Connect with Us April 2013
Provider Bulletin: Auto-Approval for Prior Authorizations System Now Live ,  Speech Therapy, Hysterectomies Require Prior Authorization effective March 1, 2013, Improved Member Eligibility Roster, Children’s Health Care and the Medicaid Managed Care Program, National Doctor’s Day, Members’ Satisfaction with Provider Communication, New Data Provided in 271 Eligibility Benefit Response Transactions, Commitment to Healthy Members and Quality Services March 2013
Provider Bulletin: Register for the Molina Healthcare Web Portal and Win Prizes, Updated Sterilization Form, Updated Sterilization Form, Members’ Satisfaction with Getting Needed Care, Commitment to Healthy Members and Quality Services, Reminder: Advanced Imagining Unit to Review Prior Authorization/Service Requests February 2013
Provider Bulletin: Self-Attestation Grace Period for 2013 Primary Care Physician Rate Increase ,  OMA Fee Schedule and Inpatient Hospital Rates Released, Healthchek, Members’ Satisfaction with Getting Care Quickly, The Importance of Care Coordination, Amended Prior Authorization Requirements effective March 1, 2013, Commitment to Healthy Members: Prenatal and Postpartum Care (PPC), Reminder: Behavioral Health CPT Coding Changes for 2013, Reminder: Advanced Imaging Unit to Review PA Requests, Partners in Care Provider Newsletter Posted January 2013
2012 Month
Provider Bulletin December 2012
Provider Bulletin November 2012
Provider Bulletin – Special Edition October 2012
Provider Bulletin October 2012
Provider Bulletin September 2012
Provider Bulletin August 2012
Provider Bulletin – Special Edition July 2012
Provider Bulletin June 2012
Provider Bulletin May 2012
Provider Bulletin April 2012
Provider Bulletin March 2012
Provider Bulletin February 2012
Provider Bulletin January 2012
2011 Month
Provider Bulletin December 2011
Provider Bulletin November 2011
Provider Bulletin October 2011
Provider Bulletin - Special Edition October 2011
Provider Bulletin - Special Edition September 2011
Provider Bulletin September 2011
Provider Bulletin August 2011
Provider Bulletin – Special Edition August 2011
Provider Bulletin July 2011
Just the Fax – EPSDT Webinars Special Edition June 2011
Just the Fax June 2011
Just the Fax April 2011
Just the Fax March 2011
Just the Fax February 2011
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