Important provider resources and policies

Resources for supporting our members:

Molina Policies

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           icon Payment Integrity Policies

 

  • Member rights & responsibilities

    Providers must comply with the rights and responsibilities of Molina Members as outlined in the Molina Member Handbook and on the Molina website. The Member Handbook that is provided to Members annually is hereby incorporated into this Provider Manual. The most current Member Rights and Responsibilities can be accessed here.

    Member Handbooks are available on Molina’s Member Website. Member Rights and Responsibilities are outlined under the heading “Your Rights and Responsibilities” within the Member Handbook document. 

    State and Federal Law requires that health care Providers and health care facilities recognize Member rights while the Members are receiving medical care and that Members respect the health care Provider’s or health care facility’s right to expect certain behavior on the part of the Members. 

    For additional information, please contact Molina at (844) 236-0894, 7:30 a.m. – 6 p.m. CT. TTY/TDD users, please call 711. 

  • Fighting Fraud, Waste, and Abuse
     

    Proper Member identification is vital to reduce fraud, waste, and abuse (FWA) in government health care programs. The best way to verify a Member’s identity is to obtain a copy of the Member’s ID card and a form of picture ID. Do you have suspicions of Member or Provider fraud? The Molina AlertLine is available to you 24 hours a day, seven days a week, even on holidays at (866) 606-3889. Reports are confidential, but you may choose to report anonymously. 

    Molina complies with all Federal and State requirements regarding fraud and abuse, including but not limited to, sections 1128, 1156, and 1902(a)(68) of the Social Security Act. 

    Additional information of Fraud, Waste and Abuse is available in the Compliance section of this Provider Manual