Important update about Molina Healthcare of Virginia

Effective June 30, 2025, Molina Healthcare of Virginia exited the Virginia Medicaid market. Beginning July 1, 2025, Cardinal Care members previously enrolled with Molina were transitioned to Humana Healthy Horizons of Virginia. We appreciate your partnership and commitment to serving Molina members. Below are key resources and deadlines to assist you with claims runout, payment disputes, and appeals.

Final claims submission deadline

All initial and corrected claims for dates of service on or before June 30, 2025, must be submitted no later than 180 calendar days from the date of service. Claims submitted after this timeframe will not be eligible for payment.

Submit claims:

• Electronically: Availity Essentials portal (Payer ID: MCC02)
• By mail:
  Molina Healthcare of Virginia
  PO Box 22656
  Long Beach, CA 90801

Provider payment disputes

If you disagree with a payment amount, denial, or adjustment, submit disputes within 365 days of the last action on the claim. Complete the appeals form and include supporting documentation (claim copy, remittance advice, medical records if applicable).

Submission options:

• Fax: (877) 553-6504
• Availity Portal: availity.com/molinahealthcare
• Mail:
  Molina Healthcare Attn:
  Provider Appeals & Disputes
  P.O. Box 36030 Louisville, KY 40233-6030

For clinical denials or service authorization disputes:

• Fax: 1-866-325-9157
• Mail:
  Molina Complete Care
  Attn: Appeals Specialist
  3829 Gaskins Road Richmond, VA 23233

For non-clinical grievances:

• Fax: (562) 499-0610
• Mail:
  Molina Healthcare
  Attn: Appeals & Grievances
  P.O. Box 22816
  Long Beach, CA 90801-9977

Continuity of care

Authorizations approved prior to July 1, 2025, will be honored by the new MCO through the approved service period or continuity-of-care timeframe. Verify member eligibility at Virginia Medicaid MES Portal