Welcome to Molina Healthcare of Illinois
Molina Healthcare (Molina) thanks providers for participating in the care of its Members. This Provider Manual is designed to assist with understanding plan policies, procedures, and other protocols for the Dual Options Program (Medicare-Medicaid Program).
The current manual is available 24/7 on the Molina website under the Manual tab. For questions, contact your Provider Network Manager or the Provider Network Management team at (855) 866-5462 or MHILProviderNetworkManagement@MolinaHealthcare.com.
Important updates and critical notifications are posted on the Provider website under the Communications tab, in the News & Updates section. Providers can register for email notifications to receive these updates automatically.
Key Information for Providers
This manual provides comprehensive guidance for providers participating in Molina Healthcare's Dual Options Program. Key sections include:
- Addresses and Phone Numbers for various departments.
- Eligibility and Enrollment criteria for Molina Dual Options Plans.
- Benefit Overviews, including coverage details and telehealth services.
- Quality improvement initiatives and provider responsibilities.
- Claims and Compensation procedures, including electronic submission.
- Credentialing and Recredentialing processes.
- Information on Cultural Competency and Linguistic Services.
- Compliance and Anti-Fraud reporting.
- Health Care Services (HCS) and Prior Authorizations.
- Behavioral Health and Pharmacy services.
Providers are encouraged to verify Member eligibility at every visit, especially before providing services that require authorization. Possession of an ID card does not guarantee eligibility or coverage.
For more information, visit MolinaHealthcare.com.
