Provider Resource Guide
Welcome to Molina Healthcare of Ohio; we are glad you made the decision to become a part of our network!
| Member Service Department | |
| Address: P.O.Box 349020 Columbus, Ohio 43234 | Phone: (800) 642-4168 TTY: (800) 750-0750 (or 711) |
The Member Services Department handles all telephone and written inquiries regarding claims, benefits, eligibility/identification, selecting or changing Primary Care Providers, and Member complaints. Member Service Representatives are available 7:00 a.m. to 7:00 p.m. Monday through Friday.
To verify eligibility, call the Member Services Department at the above number. You may also verify eligibility through the Molina Healthcare Website: http://www.molinahealthcare.com
| Claims Department | |
| Address: P.O.Box 22712 Long Beach, CA 90801 | Phone: (855) 322-4079 |
The Claims Department is located at our corporate office in Long Beach, CA. All hard copy (HCFA 1500, UB92) claims must be submitted by mail to the address listed below. Electronically filed claims must use EDI payer ID number -20149
More information about Molina Healthcare and the claims and billing processes can be found on the Molina Healthcare website: http://www.molinahealthcare.com
To verify the status of your claims, please call our Provider Claims representatives at the numbers listed above.
| Utilization Management---Referrals & Authorizations | |
| Address: P.O.Box 349020 Columbus, Ohio 43234 | Phone: (855) 322-4079 FAX: (866) 449-6843 |
The Healthcare Services Department conducts concurrent review on inpatient cases, provides case management, and processes prior authorization requests.
Referrals to network providers do not require authorization from Molina. However, requests for some services must be approved by Molina Healthcare in advance. Please see the prior authorization form for the list of procedures that require prior authorization and the instructions for submission.
You may also submit authorization requests through the Molina Healthcare Website: http://www.molinahealthcare.com
| Pharmacy Authorizations and PDL | |
| Phone: (855) 322-4079 Fax: (800) 961-5100 |
Molina Healthcare Preferred Drug List requires certain medications to be prior authorized. If you have questions regarding the Molina Healthcare Preferred Drug List and/or drug prior authorization requests you can call Molina Healthcare.
Participating pharmacies are listed in the provider directory and on our website: http://www.MolinaHealthcare.com
| Provider Services Department | |
| Address: P.O.Box 349020 Columbus, Ohio 43234 | Phone: (855) 322-4079 |
| Provider Services Representatives are available 8:00 a.m. - 5:00 p.m., Monday - Friday. | |
The Provider Services Department handles telephone and written inquiries from providers regarding address and Tax-ID changes, Provider Claim Reconsideration, contracting, and training.
Federally Qualified Health Center/Rural Health Clinic Billing Information
Following are Molina Healthcare’s Medicaid provider numbers for use when submitting documents for wrap-around payments for dates of service on and after July 1, 2013.
| Medicaid Provider Numbers | |
| Line of Business | Statewide Molina Medicaid ID Numbers |
| ABD | 0077182 |
| CFC | 0077186 |
| The Molina Healthcare office is closed on the following days: |
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| A holiday that falls on a Saturday is observed on the Friday before. A holiday that falls on a Sunday is observed the Monday after. |