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For Molina Members About Molina

Showing Information For Illinois

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Medicaid Provider Revalidations Continue

CMS requires all providers to complete the revalidation process or be disenrolled from Medicaid. Avoid disruptions in claims reimbursement and member care. Visit IMPACT for details.

Become a Molina Provider!

Click below for step-by-step instructions.

Medicaid Redeterminations Have Resumed!

Learn how this impacts you and your Medicaid patients and what you can do. Click Here

What can Availity Essentials do for you?

With Availity Essentials, you can complete enhanced member searches, make claims corrections, submit and check the status of claims, and request Prior Authorizations.

REGISTER HERE

Molina Clinical Policy Website

Access the most current Molina Clinical Policies and Molina Clinical Reviews. These policies are used by you, as well as Molina Medical Directors and internal reviewers to make medical necessity determinations.

Check It Out!

Access Free BH Tools

Explore evidence-based education opportunities from PsychHub.

Click here

Need a Prior Authorization?

Welcome, Illinois Health Care Providers

Contracted providers are an essential part of delivering quality care to our members. We at Molina Healthcare value our provider partnerships and support the doctor-patient relationship our members share with you.

Superior customer service and provider relations are one of our highest priorities. We welcome your feedback and look forward to assisting all your efforts to provide quality care.

If you have questions or concerns, please contact the Provider Network Management team at (855) 866-5462.

New P2P Scheduling Tool

Need a Peer-To-Peer review for your Molina Medicaid patient? Put in a request with our convenient new scheduling tool. CLICK HERE.

Become a Molina Provider

Would you like to become a Molina Medicaid provider? Visit our page called Join Our Network for step-by-step instructions.

Provider Education Series

Molina Healthcare of Illinois hosts provider training sessions throughout the year. Our webinars are free and open to all network providers and their medical and office staff.

Registration is quick and easy! Click here to view and register for upcoming sessions.

Automated Critical Updates! We know you’re busy. Sign up to receive provider news delivered to your inbox. Click to get started:

What's New?

Illinois Provider Feedback Survey!

Rate/Fee Schedule Updates: Dec 2024

Register for December Provider Webinars

Diagnosis Codes on Lab Claims

Don’t Miss Out on Illinois Provider Updates!

PA Application Update in Availity

Daily Unit Updates for Outpatient Therapy

Provider Revalidations Continue!

Be the Agent of Positive Change

Updates to Medicaid Pharm Policies, 4Q 2024

Recap of October Provider News

Frequently Used Forms

-   2025 Q1 Prior Auth Codification
-   2025 Q1 Prior Auth - Discontinued
-   2024 Q4 Prior Auth Codification
-   2024 Q4 Prior Auth - Discontinued
-  Q3 Prior Auth Codification - 2024
-  Q2 Prior Auth Codification - 2024
-  Q1 Prior Auth Codification - 2024
-  Q4 Prior Auth Codification - 2023

- Provider Manual (Medicaid| MMP)
- Drug Formulary (Medicaid| MMP)

-  Illinois Service Area - Hospital
-  Illinois Service Area - Ancillary
-  Illinois Service Area - FQHC
-  Illinois Service Area - Contracting
-  Illinois Service Area - Quality

- Medical Prior Auth Request Form

Find more frequently used forms here.