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Molina Healthcare

Molina Healthcare’s history and member-focused approach began with the vision of Dr. C. David Molina, an emergency department physician who saw people in need and opened a community clinic where caring for people was more important than their ability to pay. Today Molina Healthcare serves the diverse needs of more than 4 million plan

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Molina Healthcare of South Carolina, Inc. (Molina

Molina Healthcare of South Carolina, Inc. (Molina Healthcare or Molina) Molina Marketplace 2020 . The Provider Manual is customarily updated annually but may be updated more frequently as policies or regulatory requirements change. Providers can access the most current Provider Manual at .

Download: 2020_Marketplace_ProviderManual_SC_3_5_2020 FINAL 508 Compliant

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Molina Healthcare Reports Fourth Quarter and Year End 2020

About Molina Healthcare Molina Healthcare, Inc. , a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 4.0 million members as of December 31, 2020 .

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Molina HealthCare Transition Plan

Molina's’ beneficiaries were notified by Molina on July 15, 2020. Remaining Vital MCOs were notified on transition phase out process on July 17,2020. Molina's’ beneficiaries auto-assigment to new MCO will be from on August 15th, 2020 to September 14th, 2020.

Download: Molina-Healthcare-Transition-Plan-Presentation.pdf

From: asespr.org

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Molina Healthcare Announces Launch of Social Determinants

About Molina Healthcare Molina Healthcare, Inc. , a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 3.3 million members as of September 30, 2019 .

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From: investors.molinahealthcare.com

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Molina Healthcare of Washington, Inc.

Molina Healthcare of Washington, Inc. RATE SCHEDULE Counties where this plan is available King Kitsap Page 2 of 6. Individual Nongrandfathered Health Plan 84481WA0060008 Plan Information Plan Name: Core Care Bronze 1 HIOS Plan ID: 84481WA0060008 Effective …

Download: molina-individual-health-rates-2021.pdf

From: insurance.wa.gov

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PROVIDER MANUAL Molina Healthcare of Wisconsin, Inc

Molina maintains a Quality department to work with Members and Providers in administering Molina’s Quality Programs. Phone: (855) 326-5059 Fax: (800) 767-7188 . Molina Healthcare of Wisconsin, Inc. Marketplace Provider Manual Any reference to Molina Members means Molina Marketplace Members. 5

Download: 2021_Marketplace_ProviderManual_WI.pdf

From: molinamarketplace.com

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An Introduction To Passport Health Plan By Molina Healthcare

Molina Healthcare was founded in 1980 with a mission to provide quality health care to those who need it most. Today, Molina continues this mission with Medicaid and Health Insurance Marketplace products recognized by the National Committee for Quality Assurance (NCQA), and Medicare plans rated by the

Download: SEPT 23 2020 Passport by Molina Presentation.pdf

From: apps.legislature.ky.gov

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EXTERNAL QUALITY REVIEW

Molina Healthcare of New York, Inc. (Molina) is a regional, forprofit prepaid health services plan (PHSP) that - serves Medicaid (MCD), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Medicare populations. Molina Healthcare purchased Today’s Options of New York on August 1, 2016. The following report presents plan -

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From: health.ny.gov

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Molina: Healthcare update

Molina Healthcare Focus. Limited profit contracts. This is the population we understand and have served in WA. for 20 years, we feel proud to be able to help. Molina in Washington State. 4. Largest “Apple Health” plan in the state, 44% of Washington’s 1.5M members served. Chosen by about a

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From: kingcounty.gov

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PROVIDER MANUAL Molina Healthcare of Mississippi, Inc.

Molina Healthcare of Mississippi, Inc. Marketplace Provider Manual 3 Any reference to Molina Healthcare Members means Molina Healthcare Marketplace Members. If you suspect cases of fraud, waste, or abuse, you must report it to Molina. You may do so by contacting the Molina AlertLine or submit an electronic complaint using the website listed below.

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From: molinamarketplace.com

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Molina Washington Prior Authorization Form

* The Molina Healthcare Formulary is available to download onto your PDA at ePocrates.com or www.MolinaHealthcare.com. CONFIDENTIALITY NOTICE: This fax transmission, including any attachments, contains confidential information that may be privileged. The information is intended only for the use of the individual(s) or entity to which it is

Download: Molina-Washington-Prior-Authorization-Form.pdf

From: eforms.com

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2020 Provider Reference Manual Molina Healthcare

Molina Healthcare Provider Manual 2121AUG71_772312 Page 4 of 17 y Upgrades will not be authorized retrospectively (after the treatment period). y The provider must submit the Upgrade request via fax to ATA-FL at 877-583-6440. y The Upgrade Request must include the following: y The completed ATA-FL Upgrade Request Form

Download: molina-provider-manual.pdf

From: ataflorida.com

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MOLINA HEALTHCARE MEDICARE PRIOR …

Molina requires standard codes when requesting authorization. Should an unlisted or miscellaneous code be requested, medical necessity documentation and rationale must be submitted with the prior authorization request. Molina Healthcare, Inc. 2020 Medicare PA …

Download: Molina-Medicare-HMO-Auth-form-2021.pdf

From: ambulanceauth.com

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Registration

A: There are two different types of accounts for Molina Healthcare: Individual Physician and Facility/Group. Register as a Facility/Group if you intend to submit or correct claims online. Individual descriptions for each Provider Type are available on the Registration page …

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From: provider.molinahealthcare.com

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ANNUAL REPORT 2018

Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 3.8 million members as of December 31, 2018. For more information about Molina Healthcare, please

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From: molinahealthcare.gcs-web.com

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Welcome to Molina.

Molina offers healthcare services to all members without regard to race, color, national origin, age, disability, or sex. Molina does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. This includes gender identity, pregnancy and sex stereotyping.

Download: I.C.12.d Attachment - Draft Enrollee Handbook.pdf

From: finance.ky.gov

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Mail Service Order Form

Mail this form to: Number of New prescriptions: Number of Refill prescriptions: Shipping Address. To ship to an address different from the one printed above, please make changes here. New Prescriptions - Mail your new prescriptions with this form. Refills - Order by …

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From: member.molinahealthcare.com

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Molina Healthcare, Inc. Pharmacy Benefit Manager Oversight

Molina sends true errors to the PBM for confirmation and resolution . Molina requires that the PBM respond to these within one business day and any resolution is to be completed within 24 hrs. All human or systemic errors impacting at least one of Molina’s Enrollees or providers or Molina’s

Download: I.C.21.a Attachment - PBM Oversight and Surveillance Program.pdf

From: finance.ky.gov

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Molina Healthcare comment

Molina's Comments: Molina believes this provision is not feasible for many carriers and would increase healthcare costs, as it would require a carrier to have representatives available at all hours to travel to all in-state geographic areas. In addition, Molina believes …

Download: molina-healthcare-comment-stakeholder-draft-r-2019-04.pdf

From: insurance.wa.gov

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Molina Healthcare Of California Partner Plan, Inc.

Molina Healthcare of California Partner Plan, Inc. (Plan), has contracted with the State of California Department of Health Care Services (DHCS), since April 1996, under the provisions of Section 14087.3, Welfare and Institutions Code.

Download: 2019-Molina-SSS-Audit.pdf

From: dhcs.ca.gov

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Actuarial Memorandum and Certification

Molina Healthcare of Mississippi, Inc. is a licensed state health plan managed by its parent corporation, Molina Healthcare, Inc. Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through our locally

Download: 584294_7.24.2020_PartIII_ActuarialMemorandum_MS_redacted.pdf

From: ratereview.healthcare.gov

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Molina Healthcare of Florida, Inc. Practitioner Application

Molina Healthcare of Florida, Inc. - Practitioner Application Page 1 of 13 PRACTITIONER NAME: Modification to the wording or format of the Practitioner Application may invalidate the application. Molina Healthcare of Florida, Inc. Practitioner Application 1. INSTRUCTIONS This form should be: • Typed or legibly printed in black or blue ink.

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From: marchvisioncare.com

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Molina Health Care Region 4 FINAL

Molina Healthcare of Florida effective December 1, 2014 Psychcare is the mental health vendor for Molina Effective December 1st: Claims and credentialing functions managed by ValueOptions Authorization functions managed by Psychcare NEW: Effective March 1st: Authorizations, claims, and credentialing functions transferred to Psychcare

Download: Provider-Transition-Presentation.pdf

From: valueoptions.com

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MMAI Health Plan Contact Information for Providers

Welcome to Molina Healthcare Member Services: 1-855-866-5462 Welcome to Aetna Better Health Provider Services: 1-866-212-2851 Welcome to Blue Cross Blue Shield of Illinois Provider Services: 1-888-657-1211 Welcome to Humana Health Plan Provider Services: 1-800-626-2741

Download: 012918MMAIPlanContactInformationforProviders.pdf

From: illinois.gov

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Molina%Healthcare%of%California

©"2011"MolinaHealthcare,"Inc." DualEligibleChallenges% 3 Source:""Medicaid"spending"and"enrollmentes7mates"from"Urban"Ins7tute"analysis"of"datafrom"MSIS"and"CMS"

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From: dhcs.ca.gov

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MOLINA HEALTHCARE, INC.

Healthcare s stockholders. What will I be voting on? The election of three Class II directors to hold of fice until 2013, and the re-approval of the Molina Healthcare Incentive Compensation Plan. How many votes do I have? You will have one vote for every share of Molina He althcare common stock you owned on March 15, 2010, which was the record

Download: DisplayFilingRTFandXSL.aspx?filingid=7151378&type=convpdf

From: b4utrade.brand.edgar-online.com

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FEB 2 8 2019 Texas Commissioner of Insurance Official

Molina Healthcare of Texas, Inc. and I am duly authorized by said organization to execute this statement. Molina Healthcare of Texas, Inc. waives rights provided by the Texas Insurance Code and other applicable laws and acknowledges the jurisdiction of the Texas commissioner of insurance.

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From: tdi.texas.gov

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Molina Healthcare of Texas Pharmacy Provider Overview

Serving Molina Healthcare of Texas Members • Program became effective March 1, 2012 • Molina Healthcare of Texas is the managed care organization that will provide prescription drug benefit to selected State of Texas STAR, STAR+PLUS and CHIP plan members – Caremark will administer/process claims on behalf of Molina Healthcare of Texas

Download: TXMedicaid_MolinaHealthcare.pdf

From: caremark.com

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MOLINA HEALTHCARE OF SOUTH CAROLINA

Molina’s Healthcare Services (HCS) Medicaid Program Description outlines and describes the Utilization Management (UM) Program. UM policies and procedures define how utilization management, medical necessity determinations, appeals and case management services are operationalized to provide services to members. The Chief

Download: SCEQR_MolinaFinalEQRReport2018 (1).pdf

From: msp.scdhhs.gov

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Molina Healthcare of Wisconsin Tom Culhane, MD Chief

Molina Healthcare of Wisconsin. Molina is committed to NCQA as the backbone to what we offer. Molina helps patients get the care they need when they need it. Molina is focused on Medicaid and other government sponsored programs

Download: molinahcpresentation.pdf

From: dhs.wisconsin.gov

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(VERSION AS OF MARCH 15, 1996)

Molina Healthcare of Wisconsin, Inc. (MHWI), is described as a for-profit mixed model health maintenance organization (HMO) insurer. An HMO insurer is defined by s. 609.01 (2), Wis. Stat., as "a health care plan offered by an organization established under ch. 185, 611, 613, or 614 or

Download: FinMolina.pdf

From: oci.wi.gov

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Important News About Your Healthcare Coverage

Molina Healthcare of Illinois (Molina) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Molina does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Download: MolinaMemberFHPVoluntaryEnrollmentNoticeSouthernCentralILRegion.pdf

From: illinois.gov

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Infosys Helps Molina Accelerate Time To Market of

About Molina Molina Healthcare Inc., is a Fortune 500 company, based in Long Beach, California, operating health plans, clinics, and health information management solutions. It was established in 1980, when, as an emergency room physician, C. David Molina, MD, noticed that low-income, uninsured, or non-English-speaking

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From: infosys.com

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2021 Over the Counter

#2 By phone: Orders can be placed by calling . 1-888-628-2770. You can speak to a live agent Monday to Friday, from 9 AM to 8 PM EST. You can also order 24/7 through the IVR

Download: catalog_molina.pdf

From: cvs.com

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Preferred In Network Laboratories

2 MolinaHealthcare.com Federal Way Federal Way PSC 30809 1St Ave S Federal Way, WA 98003 (253) 839-1218

Download: ProviderDirectoryListing?state=WA&lob=InNetLabs&Language=1033&bid=InNetworkLabs

From: providersearch.molinahealthcare.com

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CONTRACT BETWEEN THE STATE OF MISSISSIPPI DIVISION OF

Molina Healthcare of MS, Inc., a corporation organized and existing pursuant to the laws of the State of Mississippi, which is licensed as defined by the Department of Insurance, with a principal . place of business located at, in the City of . State of . , County of

Download: MSCAN-Contract-Jul2017-June2020-Molina.pdf

From: medicaid.ms.gov

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Molina Healthcare CAHPS 5.0H Adult Medicaid Health Plan

Molina Healthcare Executive Summary New York State Department of Health ¸ DataStat, Inc. Executive Summary In New York, the CAHPS© survey is administered to Medicaid managed care …

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From: health.ny.gov

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Audit Report for Molina Healthcare of Texas, Inc. May 10, 2018

Molina Healthcare of Texas, Inc. (Molina) is a Federally-facilitated Exchange (FFE) issuer that offered Health Maintenance Organization (HMO) qualified health plans (QHPs) in the individual market in Texas during the 2014 benefit year. Molina submitted their final restated 2014 benefit

Download: 2014-CMS-APTC-Audits-Molina-Healthcare-Texas.pdf

From: cms.gov

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Creating anInstitutional Claim

The Eligibility Check section validates that the member entered is a Molina member and is eligible on and between the dates of service entered. 1. Enter the Insured’s ID from their ID card or their Last Name, First Name and Date of Birth. PLUS 2. You must enter a …

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From: provider.molinahealthcare.com

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Idaho Medicaid Plus (IMPlus) FAQ’s

YES! Idaho Duals will have the opportunity to select either Molina Healthcare of Idaho Blue Cror oss of Idaho for their Idaho Medicaid Plus plan. The enrollment begins July 1, 2018 for Twin Falls County with an effective date of October 1, 2018. Duals will have an additional ninety (90) days after October 1, 2018 to change their health plan.

Download: DisplayPDF?id=Medicaid Plus FAQ&cat=shiba

From: doi.idaho.gov

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Molina Healthcare, April 28, 2011

Molina Healthcare MO HealthNet Quality Assessment & Improvement Advisory Group April 28 , 2011 New Initiatives or events o Molina’s clinical quality improvement committee is reviewing the readmission rate which has increased over time and is developing a clinical Performance Improvement Project.

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From: dss.mo.gov

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2 0 19

Molina Healthcare of Texas (Molina) complies with all Federal civil rights laws that relate to healthcare services. Molina offers healthcare services to all members without regard to race, color, national origin, age, disability, or sex. Molina does not exclude people or …

Download: ProviderDirectoryListing?state=TX&lob=Molina Dual Options STAR PLUS MMP&Language=1033&bid=ProviderDirectoryFirst

From: providersearch.molinahealthcare.com

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Molina Medicare Model of Care

Molina Healthcare Services (HCS) staff: • Manage transitions of care to ensure that members have appropriate follow-up care after a facility stay to prevent hospital re-admissions. • Outreach to member or their representative while inpatient and post discharge.

Download: Molina-2019-MOC-Provider-Training.pdf

From: med.umich.edu

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Molina Medicare Complete Care

This plan, Molina Medicare Complete Care (HMO SNP), is offered by Molina Healthcare of Texas (When this Evidence of Coverage says “we,” “us,” or “our,” it means Molina Healthcare of Texas. When it says “plan” or “our plan,” it means Molina Medicare Complete Care (HMO SNP).) This document is available for free in Spanish.

Download: H7678_001_000_EOC.pdf

From: static.ehealthmedicareplans.com

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Claim Reconsideration Requests Update In This Issue

Molina Healthcare will honor prior authorizations for services like: coding and documentation rules Durable medical equipment Surgeries Home health services Molina Healthcare will collaborate with parents, foster families and caseworkers from Public Children Services Agencies (PCSAs) to reduce gaps in care and duplicative services.

Download: october-provider-bulletin.pdf

From: limamemorial.org

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FAQ Molina Healthcare

What is molina health care plan?

Molina Healthcare contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals who qualify for government-sponsored programs, including Medicaid and the State Children's Health Insurance Program (SCHIP).

What makes molina healthcare unique?

Molina Healthcare is a medical insurance company that knows who they are and where they are going. They compete in the government assistance health insurance market. They offer on-exchange medical plans through state and federal exchanges. That's their niche, and they have no interest in the off-exchange market.

Is molina medicaid or medicare?

Molina Medicare (Molina Healthcare) is a company that provides Medicare Advantage plans to persons on Medicare, or are Medicare and Medicaid. They offer healthcare policies in 9 states and work with lower income persons. Molina Healthcare was started by a physician who still serves as head of the company.

Is molina a health insurance company?

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.

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