Molinalogo

Adobe Acrobat Reader is required to view the file(s) below. Download a free version.

• 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