News & Updates
Our communications are a great way for providers to receive helpful information, education, important updates, and more! Our goal is to provide information to help you care for Molina Healthcare Members. Please get in touch with us at (844) 236-1464 with suggestions or comments on how we can best communicate with you. For specific concerns, please email IAProviderRelations@MolinaHealthcare.com.
Utilization Management Process Update - Effective 10/1/2024:
Sending sufficient clinical information to support a requested PA is an expectation. Beginning October 1, 2024, Molina Healthcare of Iowa asks for clinical information one time if insufficient documentation accompanies the authorization request. If not received within 24 hours, the review will be completed, likely leading to a denial.
Please see this Provider Notice for more information.
Maternal Health Provider Incentive Program
Effective September 1, 2024, Molina Iowa has implemented a new Provider Incentive Program for maternal health providers. Please see our Pregnancy Notification Form 2024 and Provider Prenatal Care Guide for more details.
Prior Authorization Requests:
We encourage all providers to start using Availity Essentials for authorizations. Please submit electronically via the Availity Essentials portal.
Reminder: for Advanced Imaging Cite Auto Auth submissions, this is done via Availity Essentials; QRG can be accessed here: Availity Essentials - Advanced Imaging Cite Auto Auth via MCG - QRG.
Additionally, here is a step by step video for this process - Availity MCG Cite Auto Auth Video.
Change Healthcare Update
Please see the latest provider bulletin regarding the Change Healthcare Outage here.
Stay in the know
Provider Advisory Council
- Molina Iowa thanks our Providers that participated in the Iowa Molina Provider Advisory Council (IMPAC). The March and November meetings for 2024 were a huge success! To be a part of this council, please complete the sign up form here. Our next virtual meeting to be in Spring 2025.
HCBS Work Group
- If you would like to be included in the work group that is held during the open forum portion of our IMPAC meeting, please sign up here and we will send you the Webex information the month prior to the meeting.
Reminder to Home Health Providers
Additional Info:
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Update from HHS October 1, 2024:
- Iowa Health and Human Services announced that the changes to Home Health Services 837i claim elements for Electronic Visit Verification (EVV) for Home Health Services (HHS) being billed on an institutional (837i) claim were required to be set up as of October 1, 2024 in the CareBridge EVV Provider portal. Please click here for more details.
- Take the first step to get set up with EVV if you haven't done so already. Go here to get registered.
POD Update
We would like your help collecting your business’ up-to-date website link, confirmation if your provider has completed cultural competency training, as well as if you have providers that are multi-lingual. You may include these in roster submissions, and/or send directly to IAPODUpdate@MolinaHealthcare.com. If there are any retired email contacts, or you want to make sure we have the best email for provider communications, please email Tiffany.Verhey@MolinaHealthcare.com.
Want regular Molina Iowa Provider Communications?
- We have partnered with Constant Contact to be our Provider communications email vendor. You will need to check your Spam/Junk folder the first time you receive to 'Accept and Release' this trusted name. For regular news, updates and announcements, sign up here!
2025 Provider Materials:
Effective January 1, 2025:
- Molina Healthcare of Iowa, Inc. Medicaid Provider Manual
- Maternal Health Providers - please see the new Newborn Notification Form
- Most up to date contact information for all departments: 2025 MHIA Provider Quick Reference Guide
- MHIA 4th Quarter Provider Newsletter
2024: Provider Materials
Provider Maps
Forms and Flyers
- Availity Reconsiderations - Secure Messaging Sunset Flyer
- Imaging Authorizations: Step by step video for Availity process for Cite Auto Auth - Availity MCG Cite Auto Auth Video
- Availity Essentials - Advanced Imaging Cite Auto Auth via MCG - QRG
- Prenatal Care Guide
- Pregnancy Notification Form 2024
- Mae - Maternal Health Flyer
- Claims Workflow Infographic
- How to Correct a Claim in Availity
- Overpayment Dispute Form
- Molina CCV Provider FAQ
- How to Read Molina EOP
2023: Provider Materials
- Molina Iowa Provider Education - October 2023
- Provider Orientation 2023
- Molina IA Claims and Billing Guide 2023
- Availity Essentials Quick Reference Guide
- Prior Authorization/Pre-Service Guide
- 90 Day Prior Authorization FAQ
- Provider Frequently Asked Questions
- Provider Reference Card
- IA Point of sale communication
- Spravato (Esketamine Nasal Spray) Billing and Coding
- Spravato (Esketamine Nasal Spray)