Molina Medicare of Ohio Provider Manual

Overview

This comprehensive provider manual is designed to equip healthcare professionals with the necessary information to effectively serve Molina Medicare of Ohio members. It details the operational framework, responsibilities, and standards for providers participating in Molina's Medicare Advantage plans.

Key Information Areas

Medicare Advantage Products: Understanding plan offerings, including Dual Eligible Special Needs Plans (D-SNPs) and regulatory updates.
Provider Responsibilities: Guidelines on nondiscrimination, data accuracy, facilities, and compliance with federal regulations like the Affordable Care Act.
Member Services: Contact details for Provider Services, Member Services, Claims, and Claims Recovery departments.
Cultural Competency & Linguistic Services: Ensuring accessible and respectful care for all members, including those with Limited English Proficiency (LEP).
Healthcare Services: Information on Utilization Management (UM), Care Management (CM), prior authorizations, and medical necessity reviews.
Quality Improvement: Molina's commitment to enhancing care quality, patient safety, and adherence to best practices.
Compliance: Protocols for preventing and reporting fraud, waste, and abuse, and adherence to relevant acts like the Deficit Reduction Act.

Resources & Support

Providers are encouraged to utilize the Molina Healthcare website for the most current information, resources, and updates. For specific inquiries or support, please refer to the contact details provided within the manual.

Access the latest provider resources and information at: www.MolinaHealthcare.com

	Molina Healthcare of Idaho, Inc. Medicare Advantage Provider Manual This manual provides essential guidance for healthcare providers on Molina Healthcare of Idaho's Medicare Advantage plans, covering provider responsibilities, benefits, claims, quality, and compliance. Access the latest information at MolinaHealthcare.com.
	Molina Healthcare of Michigan Medicare Advantage Provider Manual 2021 This Provider Manual from Molina Healthcare of Michigan, Inc. outlines the details of their Medicare Advantage plans for 2021. It covers a wide range of topics essential for healthcare providers, including plan benefits, provider responsibilities, claims submission, and compliance. The manual also details contact information for various departments and services, emphasizing electronic solutions for efficient operations.
	Molina Healthcare of Washington, Inc. Medicare Advantage Provider Manual 2021 This manual provides essential policies, procedures, and guidelines for healthcare providers working with Molina Healthcare of Washington, Inc.'s Medicare Advantage plans, covering provider responsibilities, services, quality, and compliance.
	Molina Healthcare Medicare Advantage Provider Manual 2021 This provider manual from Molina Healthcare of Texas, Inc. outlines the policies, procedures, and responsibilities for healthcare providers participating in Molina's Medicare Advantage plans for the year 2021.
	Molina Healthcare of South Carolina Provider Manual - Medicare-Medicaid 2021 This provider manual from Molina Healthcare of South Carolina details the Medicare-Medicaid 2021 plan, outlining benefits, eligibility, provider responsibilities, and claims information for the Molina DualOptions Medicare-Medicaid Plan.
	Molina Healthcare Non-Participating Provider Guide: Billing, Claims, and Contracts Comprehensive guide for non-participating providers from Molina Healthcare, covering billing guidelines, prior authorizations, claim submissions, eligibility verification, and contract requests.
	Molina Healthcare of Illinois Dual Options Provider Manual 2021 This provider manual from Molina Healthcare of Illinois, Inc. outlines the policies, procedures, and protocols for the Dual Options Program (Medicare-Medicaid Program) in 2021. It covers eligibility, enrollment, benefits, claims, and provider responsibilities.
	Molina Healthcare of Ohio Nursing Facility and Assisted Living Provider Guide A comprehensive guide for nursing facilities and assisted living providers in Ohio, detailing Molina Healthcare's policies and procedures for member care, claims submission, eligibility verification, and utilization management. Covers general information, definitions, patient liability, care management, and contact information.

Overview

Key Information Areas

Resources & Support

Related Documents