Provider Notices
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2024
- Preventive Health Guidelines Update: April 12, 2024
- Soft Drug Utilization Review (DUR) Edits (Medicaid) Effective April 8, 2024
- Webinar Opportunity - Cultural Humility & Collectivism vs Individualism - April 18 and June 13
- Provider Bulletin: Optum-Change Healthcare Outage Update April 5, 2024
- Prior Authorization Change Effective June 1, 2024
- Incorrect Rate Loaded: Home Birth Supply Kits
- Q1 2024 Provider Newsletter Available Online
- Provider Bulletin: Optum-Change Healthcare Outage Update March 18, 2024
- Adolescent Health Mini Needs Assessment
- Tribal Authorization Process
- Provider Bulletin: Optum-Change Healthcare Outage Update March 8, 2024
- Drug Formulary Change Effective April 1, 2024 (Medicaid)
- Provider Bulletin: Optum-Change Healthcare Outage Update February 29, 2024
- Provider Bulletin: Optum-Change Healthcare Outage
- Health Advisory: Unintentional Overdose Deaths Associated with Methadone and Other Opioids (Medicaid)
- BeMe: A digital solution focused on enhancing mental health and well-being for teens
- Prior Authorization Change Effective April 15, 2024 - CPT 96125
- Updated Drug Policy Effective March 1, 2024 (Medicaid)
- How to Correct a claim in Availity
- Clinical Practice Guidelines Update: January 11, 2024
- Provider Online Directory
- CMS Final Rule for CY24- Behavioral Health Changes Effective January 1, 2024
- Syphilis Screening
- Live Availity Essential Trainings: January and February 2024
- Advanced Imaging ePortal Submissions
- Updated Drug Policy Effective February 1, 2024 (Medicaid)
- 2023
- Q4 2023 Provider Newsletter Available Online
- Lead Screening Reminder for Pediatric Patients
- In-Network Clinical Laboratory Reminder
- 2024 Q1 Greater Columbia Provider Forum: January 9, 2024
- Save the Date! Greater Columbia Provider Forum
- Council for Affordable Quality Healthcare Exclusive Credentialing Vendor Effective January 1, 2024
- Drug Formulary Change Effective: January 1st, 2024 (Medicaid)
- Secure Messaging from Claim Status Screen Enabled in Availity Essentials Portal
- Submit and Track your Appeals on Availity Essentials
- Explanation of Payment Refund and Forwarding Balance Reporting Enhancement
- Your Feedback is Important! Molina Healthcare 2023 Provider Satisfaction Survey
- Updated Drug Policy Effective December 1, 2023
- Preventive Health Guidelines (PHGs) Update: November 6, 2023
- Synagis® 2023-2024 Policy Update Effective November 2, 2023
- Updates to HCA's Telemedicine Billing Codes: Effective October 1, 2023
- Synagis® 2023-2024 Prior Authorization Form Available Now Effective October 15, 2023
- Prior Authorization Change Effective December 1, 2023
- Preventive Health Guidelines (PHGs) Update: October 2, 2023
- Joint MCO Live Training Sessions for Apple Health Medicaid Providers
- Provider Tips to Increase Flu Vaccinations CY23-24: October, 2023
- Live Availity Essentials Trainings: October, November and December 2023
- Health Care Authority's Clinical Data Repository
- Prior Authorization Change Effective December 1, 2023
- Effective Immediately: Molina's Provider Online Directory to Display Maximum of Five Service Locations Per Provider
- Live Availity Essentials Trainings: September and October 2023
- Lynx Healthcare Pain Management Clinic Closed: Effective September 8, 2023
- Flu Vaccine Incentive CY23-24: September 1, 2023 - February 29, 2024
- Molina 2023 Q3 Spokane Provider Workshop & Luncheon: October 10, 2023
- Drug Formulary Change Effective: October 1, 2023 (Medicaid)
- Drug Formulary PDL Changes Effective: October 1, 2023 (Medicaid)
- Washington Administrative Code Reminder
- Washington State Autism Center of Excellence Certificate Training: September 29, 2023
- Q3 2023 Provider Newsletter Available Online
- Updated Medicaid PO Box for Provider Claim Disputes and Appeals
- Wildfires-Molina's Disaster Response
- Preventive Health Guidelines (PHGs) Update: August 4, 2023
- Help Your Molina Medicaid Members Restore Their Coverage
- August and September Live Availity Trainings
- Availity Essentials Core Features
- Home Health National Provider Identifier (NPI) Registration Requirement Updates
- Member Well-Care Visit (Ages 6-17) Back to School Promotion: July 1 - October 31, 2023
- Prior Authorization Change Effective October 1, 2023
- Explanation of Payment Refund and Forwarding Balance Reporting Enhancement
- New – 90-Day Medication Refills Policy: July 2023
- Preventive Health Guidelines (PHGs) Update: July 13, 2023
- Unleash the Power of Oral Health with Mouth Matters and Acora Foundation
- July and August 2023: Live Availity Essentials Trainings
- Updated Drug Policy Effective July 1, 2023
- Molina's Peer-to-Peer Request Timeframe Updated: Effective July 1, 2023
- Live Availity Trainings: June and July 2023
- Preventive Health Guidelines: Updated April 2023
- Skilled Nursing Facility: Exceptional Care Needs Program Effective May 30, 2023
- Molina 2023 Q2 SW WA Provider Workshop & Luncheon: June 20, 2023
- Availity Essentials is Molina Healthcare's Exclusive Provider Portal Effective June 22, 2023
- Skilled Nursing Facility (SNF) Admissions Effective May 1, 2023
- Pharmacy Recredentialing Notice (Medicaid)
- Prior Authorization Change Effective July 1, 2023
- Live Availity Trainings: May and June 2023
- Admit Discharge Notifications and Certificates of Acknowledgements
- Payment of Oral Food Thickeners Billed under HCPCS Code B4100
- Update: EPSDT Well-Child Periodicity for Middle Child and Adolescence
- Member Renewal Date in Availity
- New Century Health Updated eFax Numbers
- Availity Essentials Migration Schedule Change/Update
- Q2 2023 Provider Newsletter Available Online
- Live Availity Overpayment and General Trainings: March and April 2023
- Home Health National Provider Identifier (NPI) Registration Requirements Update
- Virtual Intensive Engagement Wraparound (VIEW) Webinar
- Q1 2023 Provider Newsletter Available Online
- Updated Drug Policy Effective April 1, 2023 (Medicaid)
- Prior Authorization Change Effective February 1, 2023
- Explanation of Payment Refund Reporting Enhancement in ECHO
- Clinical Practice Guidelines and Preventative Health Guidelines Update: February 23, 2023
- Drug Formulary Change Effective: April 1, 2023 (Medicaid)
- Updated Drug Policy Effective: April 1, 2023 (Medicaid)
- Submit ICD-10 Values for ADHD Drug Classes (Medicaid)
- Behavioral Health Integration Grant Webinar on February 27, 2023
- Upcoming Drug Policy Changes Effective: March 1, 2023 (Medicaid)
- Opioid MME Edit Update (Medicaid)
- Avalon Laboratory Management Program Go-Live Delayed-Medicaid
- Live Availity Trainings: February and March 2023
- Clinical Practice and Preventative Health Guidelines Update
- Prior Authorization Change Effective April 1, 2023
- New Drug Policy Effective February 1, 2023 (Medicaid)
- Provider End of Medicaid Extension Resources
- Prior Authorization Notification HCPCS A4927
- Online Provider Directory
- Molina to Partner with Healthmap Solutions, Inc for Medicaid Effective 2/1/2023
- Coming Soon! New Availity Essential Portal Functionalities
- Clinical Trial Process Changes Effective October 1, 2022
- Clinical Trial Process Changes: Washington Health Care Authority Clinical Trials FAQs
- Drug Formulary Change Effective: January 1, 2023 (Medicaid)
- Drug Formulary Additional Changes Effective: January 1, 2023 (Medicaid)
- Update Jail Release and Needed Medical Services
- 2022
- Checking Appeal Status in Availity Payer Spaces
- Limited Time Offer: Flu Vaccine Member Reward - CY22-23 Flu Season
- Laboratory Benefit Management Program Launch Beginning February 23, 2023
- Molina Legacy Provider Portal Sunset Notice-Effective March 28, 2023
- Availity to Molina Legacy Portal SSO Re-enabled December 5, 2022
- HB 1860: Inpatient Behavioral Health Discharges for Those with Homelessness and Housing Instability Effective January 1, 2023
- HB 1860 – Housing Related Care Coordination and Discharge Notification Training Flyer
- Reminder: 2022 Provider Satisfaction Survey
- Change Healthcare ProviderNet Sunsetting Notice
- New Payment Integrity Clinical Code Edits
- EPSDT Well-Child Visits Periodicity Effective January 1, 2023
- Fall 2022 Provider Newsletter Available Online
- Provider Tips to Increase Flu Vaccinations - CY22-23 Flu Season
- Skilled Nursing Facility (SNF) Admissions During the COVID-19 Public Health Emergency Effective November 7, 2022
- Prior Authorization Change Effective January 1, 2023
- Notice of Change in Process for Incorrect Paper Claims Address
- Synagis® 2022-2023 Prior Authorization Form Available Now
- Entering Multiple Prior Authorization Requests in Availity Payer Spaces
- Initial Prenatal Visit and Code 0500F Requirement
- Update to Enteral Nutrition Billing for DME Suppliers
- Mental Health Assessment for Young Children -Implementation Survey
- Joint MCO Live Training Sessions for Apple Health Providers
- Behavioral Health Services Only (BHSO) FAQ
- Reminder: New Century Health Oncology Prior Authorization Effective November 1, 2022
- Update Jail Release and Needed Medical Services
- Change Healthcare Settlement Advocate Migration with ECHO Health Inc.
- Newborn Administrative Day Rate Effective October 1, 2022
- Molina Healthcare 2022 Provider Satisfaction Survey
- Billing for Enteral Nutrition Services
- Live Availity Trainings in September and October 2022
- IMPORTANT NOTICE: Oncology Quality Management Vendor New Century Health
- Updated Sterilization Consent Form Available
- Prior Authorization Changes Effective October 1, 2022
- Guidelines and Instructions for Paper Claim Submissions
- Interoperability Language Added to Provider Manuals
- Set Up Your Payment Preference with ECHO Health, Inc Today!
- ProviderNet Service Portal Outage
- Expedited Authorization (EA) Codes (Medicaid)
- Live Availity Trainings in July and August 2022
- Over The Counter (OTC) Contraceptives
- Limited Time COVID-19 Vaccine Incentive for Apple Health Members
- July 2022 Apple Health PDL Changes
- Spring 2022 Provider Newsletter Available Online
- Update Regarding Molina's Peer-to-Peer Process and Reconsideration Requests Effecting July 25, 2022
- Live Availity Essentials Trainings in June 2022
- April 2022 Apple Health PDL changes
- Live Availity Essentials Trainings in May 2022
- June 2022 Drug Policy Change- Serotonin Modulators
- June 2022 Drug Policy Change - Cabenuva
- June 2022 Contraceptive - Expedited Authorization
- May 2022 Drug Policy Change
- Prior Authorization Change Effective July 1, 2022
- New Patient Review and Coordination Phone Number
- New Covid-19 Monoclonal Antibodies HCPCS Codes
- Dementia Care Planning for Medicaid Members
- Updates on the Consent for Sterilization Form
- Updates to Non-Registered NPI Requirements and Recoveries
- Services Covered Under Behavioral Health Services Only
- Payment Policy Update: Outpatient Definitive and Presumptive Drug Testing ON HOLD
- Winter 2022 Provider Newsletter Available Online
- Billing and Rendering Taxonomy Requirements
- April 2022 Additional Formulary Changes
- April 2022 Drug Formulary Changes
- Mental Health Practitioner Travel Reimbursement
- Pharmacy Re-Credentialing Notification
- Update of Vision Services Billing for Medicaid Members
- Update of Vision Services Billing for Medicaid Members – Coding Reference
- Over-the-Counter (OTC) COVID-19 tests Pharmacy FAQ
- Availity Features
- Legacy Provider Portal New User Registration Ending
- Prior Authorization Change Effective April 1, 2022
- Online Provider Directory
- TeleBehavioral Health Training
- Check Printing Error
- Drug Policies Effective February 1, 2022
- Online Provider Directory
- 2021
- New Fax Number for Discharge Planning/In Lieu of Authorizations Effective January 1, 2022
- WIC Provider Medical Documentation Form Grace Period Removal
- Fall 2021 Provider Newsletter Available Online
- Members' Molina ID Cards May Be Delayed
- NCQA Recognition
- Provider Tips to Increase Flu Vaccinations
- Hospital Discharges and SNF Incentive Effective December 1, 2021
- Billing Taxonomy Requirements
- Drug Formulary Change Effective January 1, 2022
- Action Required: Billing and Non-Billing Enrollment Requirements, Potential Recoveries and Future Claim Denials
- COVID-19 Vaccine Member Reward - Limited Time Offer
- Natural Disaster
- Flooding in WA - Disaster Response
- Readmission Update Effective January 15, 2022 - New Admission Where Patient Left Against Medical Advice (AMA)
- Upcoming Drug Policy Changes Effective December 1, 2021 – Isotretinoin
- COVID-19 Provider Resources for Apple Health HCA Updated Policy Effective October 1, 2021
- Reminder: 2021 Provider Satisfaction Survey
- Outpatient Definitive and Presumptive Drug Testing Update Effective January 1, 2022
- Prior Authorization Changes Effective January 1, 2022
- Washington Joint MCO Training Session for Apple Health Providers
- SUPPORT ACT Changes to Prescription Monitoring Program Effective October 1, 2021
- Summer 2021 Provider Newsletter Available Online
- Upcoming Drug Policy Changes Effective December 1, 2021 – Atopic Dermatitis Agents: Crisaborole (Eucrisa™)
- Upcoming Drug Policy Changes Effective December 1, 2021 – Antivirals: HIV - rilpivirine (Edurant®)
- Synagis® 2021-2022 Prior Authorization Form Available Now
- Billing and Non-Billing Enrollment Requirements, Potential Recoveries and Future Claim Denials
- 2021 Provider Satisfaction Survey
- Drug Formulary Change Effective October 1, 2021
- Upcoming Drug Policy Changes Effective October 1, 2021 – Antineoplastics and Adjunctive Therapies - Imidazotetrazines
- Partial Approval/Partial Denial Process Effective August 2021
- Change to Cardiology Prior Authorization Process Effective October 1, 2021
- Wildfires-Disaster Response
- Prior Authorization Change Effective October 1, 2021
- Automatic Refills for Prescriptions Effective July 1, 2021
- Free Center of Excellence Certification Training - Autism Spectrum Disorder - September 24, 2021
- COVID-19 Vaccine Survey Distribution
- Molina Healthcare is Moving to a New Online Provider Directory
- Cotiviti to Conduct Post-Payment Reviews of Inpatient Claims
- Drug Policy Changes Effective August 1, 2021
- 2021 Clinical Practice and Preventive Health Guidelines
- Spring 2021 Provider Newsletter Available Online
- Pharmacy Benefit Change Effective July 1, 2021
- Molina is Moving to a New Online Provider Directory
- Molina's Exclusive Provider Portal is Changing to Availity
- Dive in to Availity's Capabilities with a Free Webinar
- FAQs for Providers about Medicaid Member Assignment
- Molina is Changing to Availity - Free 30-Minute Webinar Training
- Buprenorphine - Expedited Authorization Effective July 1, 2021
- Drug Formulary Change Effective July 1, 2021
- Upcoming Drug Policy Changes Effective June 1, 2021
- Prior Authorization Change Effective August 1, 2021
- Upcoming Drug Policy Changes Effective June 1, 2021
- Prior Authorization Change Effective July 1, 2021
- Expedited Authorization for Hormone Therapy
- Molina Healthcare Provider Toolkits
- Upcoming Drug Policy Changes Effective May 1, 2021
- Winter 2021 Provider Newsletter Available Online
- Delay to New Century Health (NCH) Transition for Cardiology Prior Authorization
- One Revised Thrombopoiesis Simulating Proteins Policy Effective April 1, 2021
- Two Revised HIV Drug Policies Effective April 1, 2021
- Service Encounter Reporting Instructions (SERI) Effective July 1, 2021
- Change to Prior Authorization Change Gen Cancer Care Effective February 3, 2021
- Potentially Preventable Readmissions Resources
- COVID-19 Vaccine Billing Guidance & More
- Prior Authorization Change Gen Cancer Care Effective February 3, 2021
- Prior Authorization Change Psychological Test Effective February 12, 2021
- Upcoming Drug Policy Changes Effective March 1, 2021
- Provider Online Directory
- Change to Cardiology Prior Authorization Process Effective April 1, 2021
- Prior Authorization Change Effective April 1, 2021
- Free Remote Autism Certification Training
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) Provider Toolkit
- 2020
- COVID-19 Vaccine Resources Now Available
- Proton Pump Inhibitors (PPIs) Prior Authorizations
- HIV Combinations Expedited Authorization Effective January 1, 2021
- Drug Formulary Change Effective January 1, 2021
- Cotiviti Modifier Correct Coding Validation Effective January 1, 2021
- MCG Provider Notification Effective January 31, 2021
- FAQs for MCG Criteria Effective January 31,2021
- COVID-19 Provider Resources
- COVID-19 Hospital Discharges & SNF Admissions
- Prior Authorization Change Effective January 1, 2021
- Prior Authorization Change Behavioral Health Substance Use Disorder Effective January 1, 2021
- Washington Apple Health Provider Training
- CDC Guidelines for COVID-19
- Prior Authorization Changes Effective August 1, 2020
- Drug Formulary Change Effective July 1, 2020
- New Duration of Use and Dose Limits for Proton Pump Inhibitors (PPI)
- COVID-19 Telehealth Billing
- Molina Expands Pharmacy Benefit Coverage for Continuous Glucose Monitors
- Drug Formulary Change Benzoyl Peroxide Products Effective June 1, 2020
- Drug Formulary Change Fexofenadine Effective June 1, 2020
- Drug Formulary Change Lansoprazole 15mg Over the Counter (OTC) Effective June 1, 2020
- Drug Formulary Change Effective June 1, 2020
- Formulary Change Over the Counter (OTC) Products Effective June 1, 2020
- Molina Expands Pharmacy Benefit Coverage for Continuous Glucose Monitoring and Supplies
- Service Encounter Reporting Instructions (SERI) Changes Effective April 1, 2020
- E/M Code Edit Reviews Effective June 1, 2020
- Medicare Opioid Treatment Benefit Effective January 1, 2020
- COVID-19 Provider Resources
- Applied Behavioral Analysis (ABA) Therapy Prior Authorization Changes Effective May 12, 2020
- Great Rivers Region Behavioral Health Provider Update
- Definitive Urinalysis Drug Testing Codes Prior Authorization Changes Effective April 21, 2020
- IMC Prior Authorization Changes Effective April 1, 2020
- New 90 Day Medication Refill Policy
- Salish Region Integrated Managed Care (IMC) and PCP Assignment
- Educational Opportunities - Treating Patients with Opioid Use Disorder and Autism Spectrum Disorder
- 2019
- IMC Dental-Related Services Covered by Integrated Managed Care (IMC) Health Plans Effective January 1, 2020
- Washington Admin Simplification Supporting Prior Authorization Process
- Dr. Fishman Opioid Training
- Prior Authorization Change to Vaccines
- Washington Dual Model of Case Training
- Winter 2019 Provider Newsletter Available Online
- Apple Health (Medicaid) Integrated Managed Care 2020 Regional Update
- Re-Registration Required for Popular HCA Webinar on Criminal Justice/BH Treatment
- 2020 WA State Traumatic Brain Injury Conference
- Assistance is Available for Providers Transitioning to Integrated Managed Care (IMC)
- Common Behavioral and Physical Health Co-Morbidities
- Behavioral Health Integration for Primary Care Providers
- Update to Molina's Peer-to-Peer and Reconsideration Process Effective November 4, 2019
- Problem Solving Treatment for Patients with Depression
- Fentanyl Warning Blast Fax
- Hepatitis A Outbreak in Washington State
- REQUIRED: 2019 Joint Medicaid Provider Training
- Provider Resources & Upcoming Behavioral Health Trainings
- Health Care Authority's Behavioral Health Data Guide Now Available
- Drug Formulary Update Effective August 1, 2019 - Cough and Cold Products
- Say It Out Loud Spokane October 29, 2019
- Behavioral Health Training and Grant Opportunities
- Opioid SUPPORT Act Letter from the Washington Health Care Authority
- Durable Medical Equipment (DME) Requirements for Miscellaneous Codes Effective October 1, 2019
- Vaccine Prior Authorization Change Effective January 1, 2020
- Optum PrePayment Claim Reviews
- Drug Formulary Change Effective October 1, 2019
- Using Patient Decision Aids With Your Patients
- Prior Authorization Changes E2300 Effective November 1, 2019
- Non-preferred Incontinence Provider Notification
- Preferred Incontinence Provider List for Molina Apple Health (Medicaid)
- Suicide Prevention Training Opportunities
- Vaccine Prior Authorization Changes Effective October 1, 2019
- BH and SUD Resources Now Available
- Service Encounter Reporting Instructions (SERI) Updates Effective July 1, 2019
- Prior Authorization Changes A9604 Effective October 1, 2019
- Prior Authorization Changes Apple Health Effective October 1, 2019
- Health Care Authority (HCA) Update - Standardized Non-Encounter Data Set Begins January 2020
- Reducing Evaluation and Management Billing Errors-Change Healthcare (CHC) Coding Advisor Notification
- Apple Health Integrated Managed Code Going Live in the North Sound Region Effective July 1, 2019
- Spring 2019 Provider Newsletter Available Online
- Prior Authorization Changes HCPCS Code A6549 Effective August 1, 2019
- One Key Question Training
- Where to Send ProviderOne Updates for Molina Healthcare
- Medicaid What's Covered - Private Duty Nursing
- Department of Health Free Buprenorphine Waiver Trainings
- New Sepsis Guidelines
- Overview of Wraparound with Intensive Services (WISe) State Program
- Medicaid Prior Authorization Pre-Service Review Guide Effective January 1, 2019
- Pre-Service Directory Now Available
- Measles Outbreak in Clark County - Resources for You and Your Patients
- 2019 Behavioral Health Provider Survey
- PAL for Moms Blast Fax 2019
- POD Mental Health List Notification
- 2018
- Winter 2018 Provider Newsletter Available Online
- Change to Claim Management for Missing or Incorrect Member Information Effective December 7, 2018
- Confluence Change Effective January 1, 2019
- Free Smoking Cessation Program for Molina Apple Health Patients Effective November 6, 2018
- Prior Authorization Cardiac Effective January 1, 2019
- Prior Authorization Changes Joint Replacement Effective January 1, 2019
- Prior Authorization Changes CGM Supplies Effective January 1, 2019
- Clarification of Vision Billing Services – VSP Helpful Hints
- MHW 2018 Joint Medicaid Provider Training
- Private Daily Nursing Changes Effective December 15, 2018
- Medication Assisted Therapy Reimbursement Project
- Drug Formulary Update Effective October 1, 2018
- Prior Authorization Changes K0903 Diabetic Insert Effective October 15, 2018
- Summer 2018 Provider Newsletter Available Online
- Molina Accredo Physician
- Vision Service Provider Change Effective September 1, 2018
- Prior Authorization Changes Bariatric Surgery Program Effective August 13, 2018
- Drug Formulary Update Effective July 1, 2018
- Prior Authorization Changes Continuous Glucose Monitors Effective July 1, 2018
- Prior Authorization Changes Genetic Testing Effective July 1, 2018
- Prior Authorization Changes Hyaluronic Acid Effective July 1, 2018
- Provider Dispute Request Process May 2018
- Requirement Reminder: In-Network Labs April 2018
- Prior Authorization Changes Effective April 1, 2018
- Provider Referral From Weight Watches Updated March 2, 2018
- Molina Transitioning to Inpatient InterQual Care Guidelines
- POD Mental Health List Notification
- RHC Encounter Billing 2018
- IMC Interpreter Services 2018