Provider Orientation
Provider Orientation
2023 | Molina Healthcare
MHO-PROV-0119 0623
Agenda
? Provider Resources ? Availity Essentials Portal ? Quality ? Pharmacy ? Health Care Services (Utilization Management/Care Management) ? Billing and Claims ? Appeals and Grievances ? Compliance ? Provider Training ? Contact Molina
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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 served approximately 5.1 million members nationwide.
Medicaid: Provides a member-centered approach with a wide range of quality health care services to families and individuals who qualify for governmentsponsored programs
Medicare: Medicare Advantage plans designed to meet the needs of individuals with Medicare
MyCare Ohio: A member-centered health care approach for people who are eligible for both Medicare and Medicaid
Marketplace: Offers plans that remove financial barriers to quality care and keep members' out-of-pocket expenses to a minimum
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Provider Resources
Provider Services
Satisfaction Communication
Technology
? Provider Services Representatives and Engagement Teams
? Annual Assessment of Provider Satisfaction
? The It Matters to Molina Program that Includes Monthly Forums, surveys, and an Information Page on the Provider Website
? Provider Bulletin and Provider Newsletters
? Online Provider Manuals ? Online Trainings, Health
Resources, and Provider Resource Guides ? Secure Messaging on the Availity Essentials Provider Portal (Availity)
? 24-hour Provider Portal ? Online Prior Authorization
and Claim Dispute Submission ? Supplemental Prior Authorization (PA) Lookup Tool on Provider Portal and Provider Website ? MCG Auto-Authorization for Advanced Imaging PA Submission ? Availity Overpayments
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