Claims Submission

As a participating provider with Molina, you have established a contractual agreement to provide physical, behavioral and/or other long-term support services to our members. The arrangement is fee-for-service for the provision of covered healthcare services unless otherwise specified under your Participating Agreement. The rates established in your Participating Agreement are considered full payment for covered services provided. Accordingly, Molina members may not be balance billed for any remaining amounts and/or difference between what is billed, and your negotiated reimbursement rates defined in the rate exhibit of your Participating Provider Agreement.

  • How do I submit my claims to Molina?

    You can submit your claims to Molina by paper or electronically. You are strongly encouraged to submit your claims electronically. Electronically transmitted claims result in faster claims payment turnaround times and higher acceptance rates. However, if you choose not to bill electronically, we can accept paper claims.

    Submitting Electronic Claims

    Molina uses Change Healthcare as its gateway clearinghouse. Change Healthcare has relationships with hundreds of other clearinghouses. There are several other claims clearinghouses that we work with. Please call Customer Care to check if Molina has a relationship with your clearinghouse. Molina's clearinghouse payer ID for both Medicare and Medicaid claims is MCC02. The MCCVA Payer ID will no longer be accepted effective 7/1/2022.

    Molina also offers a direct submit/web-based claims option through Availity Essentials Provider Portal to Molina for both Medicaid and Medicare claims. As of November 19, 2022 you will need to have a premium subscription with Availity to submit EDI batch claims. There is no charge to participating providers for submitting direct data entry claims through the Availity tools.

    You must register with Availity to use the service and add Molina Healthcare Virginia as one of your payers. If you are not currently registered with Availity please visit to get connected.

    Submitting Paper Claims

    Participating Providers should submit Claims electronically. If electronic Claim submission is not possible, please submit paper Claims to the following address:

    Molina Healthcare of Virginia, LLC
    PO Box 22656
    Long Beach, CA 90801

    Please keep the following in mind when submitting paper Claims:

    • - Paper Claims should be submitted on original red colored CMS 1500 Claims forms.
    • - Paper Claims must be printed, using black ink.