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Molina Healthcare provides a holistic, community-based approach designed specifically to meet the individual needs of our members, includes Medicaid, Medicare and Marketplace offers.
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Molina Healthcare has a list of resources to help you with health care choices to the most of your services.
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At Molina Healthcare, we believe everyone deserves quality healthcare. We help people, families and communities get the care they need. Our plans to fit each member.
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Welcome, South Carolina healthcare providers

Partner with Molina Healthcare to deliver quality care. Use our portal, tools, and support to care for your patients.

See the latest South Carolina provider updates

Find announcements, prior authorization changes, and newsletters to keep your practice informed.

PROVIDER

Provider support

Do more in the Availity provider portal

Work faster with real-time tools that help you manage members’ care:

Check eligibility and benefits
Submit and track claims
Review remits and payments
Start and check authorizations
Submit claims disputes and appeals

Need assistance? Find your Provider Relations

representative or contact Provider Services at (855) 237-6178.

Get provider tools and resources

Quick links to common tasks

Availity provider portal

Click here

Claims and payments

Click here

Molina Help Finder

Click here

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Education, programs and tools

Explore training, behavioral health resources and quality programs.

Provider education and training

Find resources and training on technology, processes, and more.

View now

Behavioral health resources

Get information on screenings, education, and other guidance to support members’ behavioral health.

See Behavioral Health Toolkit

Provider Manual

Find what you need, including the grievance and appeals process, provider and member rights and responsibilities, and more.

Read the Molina Healthcare Provider Manual

Quality and HEDIS support

Access guidance, reminders, and results to improve care.

View quality resources

Report Fraud, Waste, and Abuse

Compliance is everyone’s responsibility. Use our online or phone resources to speak up.

Report FWA online

Update your directory information

Visit our Provider Online Directory to update your office location, hours, and contact information.

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Utilization management criteria

Molina uses clinical standards recognized by:

South Carolina Medicaid
ASAM
InterQual® criteria
Molina Clinical Policies and posted medical guidelines

Providers may request copies of the criteria used in any determination.

How Molina makes medical decisions

UM decisions follow federal and state rules for medical necessity and are made by licensed clinicians using:

Medical records
Clinical guidelines
Evidence based standards

Peer to peer reviews and reconsiderations are available.

Where to access all PA and UM materials

Publicly posted resources include:

Prior Authorization Pre Service Review Guide
Clinical policies
Pharmacy PA rules
Preferred Drug List (PDL)

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Contact Molina Healthcare of South Carolina

We are here to help with Availity provider portal access, claims, authorizations, and contracting questions.

Phone: (855) 237-6178

Address: Molina Healthcare of South Carolina PO Box 40309 North Charleston, SC 29423-0309 Provider Services Hours: Monday through Friday, 8 a.m. to 5 p.m., local time

Helpful links for South Carolina providers

Use these links to manage your daily tasks.

Prior Authorization Request Form

Behavioral Health Prior Authorization Form

Contract Request Form

Prior Authorization Pre-Service Review Guide

Credentialing Packet

Provider Manual & Orientation

Provider Online Directory

Availity Essentials

Frequently Used Forms / Resources

Provider Newsletters

Behavioral Health Stigma

Town Halls

DHHS Provider Manuals

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Need assistance? We are here to help.

Call us at (855) 237-6178 Join Our Network

Important information

This page is for providers serving South Carolina Molina members. For enrollment verification, use the Availity provider portal. For full policies and authorization lists, see the provider manual in the portal.