Important provider resources and policies

For all your Non-Emergent Medical Transportation (NEMT) needs, please contact Veyo at (800) 424-4524 for CCC Plus members, and (800) 424-4518 for Medallion 4.0 members.

MCC encourages electronic payment of your claims remittance. In order to get your claims payment direct deposited into your bank account, please complete and return this enrollment form, along with all requested documentation within the form. Return the documentation to MCCVA-Provider@MolinaHealthcare.com.

  • Filing an appeal with MCC

    Provider appeals are requests made by the MCC providers (in-network and out-of-network) to review MCC’s adverse benefit determination in accordance with the statutes and regulations governing the Virginia Medicaid appeal process. After a provider exhausts MCC’s internal appeal process, Virginia Medicaid affords the provider the right to two (2) administrative levels of appeal (informal appeal and formal appeal) in accordance with the Virginia Administrative Process Act (Code of Virginia Section 2.2-4000 et seq.) and Virginia Medicaid’s provider appeal regulations (12 VAC 30-20-500 et seq.).

    Providers may submit reconsiderations to MCC if a provider has rendered services to a member and has been denied authorization/reimbursement for services or has received reduced authorization/reimbursement.

    A provider may file an appeal with MCC within 60 calendar days from the date of the adverse benefit determination notice/remittance advice. Failure to file an appeal with MCC within this time frame shall result in an administrative dismissal.

    A provider must file the appeal with MCC in writing, although the appeal may be started verbally. The appeal must identify the issues, adjustments, or items the provider is appealing and include any supporting documentation, which explains or satisfies the reason for the original denial and why it should be paid accordingly.

    There are several ways to file an appeal:

    • By phone
      • Call Customer Care Monday through Friday from 8 a.m. to 6 pm. local time. Providers may leave a message after hours that will be returned the next business day.
        • CCC Plus: (800) 424-4524
        • Medallion 4.0: (800) 424-4518
    • By mail
      • Send your appeal request to:
        Molina Complete Care
        Attn: Complaint Coordinator
        PO Box 36030
        Louisville, KY 40233-6030
    • By secure email
    • By fax
     

    Download a copy of our Appeals Form

    For more information about provider appeals, refer to your provider manual.