For Molina Members About Molina
Type Size:
We use cookies on our website. Cookies are used to improve the use of our website and analytic purposes. By using our website, you consent to our use of cookies in accordance with our Privacy Policy. Read more . I agree

Welcome, South Carolina Healthcare Providers

Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members. As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all of your efforts to provide quality care.

If you have any questions, please call Provider Services at (855) 237-6178.

Provider Dispute and Appeals Submissions

Molina has gone green, and is requesting that all providers submit provider dispute and appeals electronically. Electronic submission provides benefits to providers including faster disputes and appeals processing, increased overall efficiencies, improved processing accuracy and reduced HIPAA violations.

Any disagreement regarding the processing, payment or non-payment of a claim is considered a provider dispute. Provider disputes are typically disputes related to overpayment, underpayments, untimely filing, missing documents (i.e. consent forms, primary carrier explanation of benefits) and bundling issues. Provider Appeals are requests related to a denial of an authorization or medical criteria. A provider has 90 days from date of remittance denial to dispute a claim.

Molina offers the following submission options:

  • Submit requests directly to Molina Healthcare of South Carolina via the Provider Portal at: https://provider.molinahealthcare.com
  • Submit requests directly to Molina Healthcare of South Carolina via fax at (877) 901-8182
  • Submit Provider Disputes through the Contact Center at (855) 882-3901
  • Submit requests via mail to:
    Molina Healthcare of South Carolina
    Provider Dispute and Appeals
    PO Box 40309
    North Charleston, SC 29423-0309
  •  

What’s New

  • Prior Authorization Updates.(Coming Soon)
  • BH Toolkits and HEDIS Tip Sheets.(Coming Soon)
  • ​​​​​

    Webinars and Training Sessions

    Be on the lookout for upcoming webinars, orientations and educational sessions.​​

    Important Reminder

    Please notify Molina Healthcare at least 30 days in advance when you have any of the following:

    • • Change in office location, office 
         hours, phone, fax, or email
    • • Addition or closure of office location
    • • ​Addition or termination of a provider
    • • Change in Tax ID and/or NPI
    • • Open or close your practice to new
         patients (PCPs only)
    ​​

    You are leaving the Molina Medicare product webpages and going to Molina’s non-Medicare web pages. Click Ok to continue.

    This link will take you away from the Dual Options section of MolinaHealthcare.com

    You are about to leave the Molina healthcare website. Click Ok to continue.

    This link will take you away from the Dual Options section of MolinaHealthcare.com

    You are leaving the Molina Medicare product webpages and going to Molina’s non-Medicare web pages. Click Ok to continue.

    You are leaving the Molina Healthcare website. Are you sure?