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MOLINA HEALTHCARE ANCILLARY PROVIDER LIST NameNPILic. NumberSpecialtyMedicaid # (If applicable)Medicare # (If applicable)Please complete and return to Molina Healthcare at: Attention: Provider Services
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How to fill out molina healthcare ancillary provider

01
Gather all required information such as your personal details, provider number, and any supporting documentation.
02
Access the Molina Healthcare website or contact their customer service for the ancillary provider application form.
03
Carefully read the instructions and fill out the form accurately. Provide all necessary details and attach any requested documentation.
04
Review the completed application to ensure everything is filled out correctly and all required documents are attached.
05
Submit the application either online, by mail, or through the designated submission method specified by Molina Healthcare.
06
Wait for the application to be processed. You may receive a notification or request for additional information during this time.
07
Once approved, you will receive confirmation and further instructions on how to proceed as an ancillary provider with Molina Healthcare.

Who needs molina healthcare ancillary provider?

01
Individuals or organizations providing ancillary healthcare services or products may need Molina Healthcare's ancillary provider services.
02
These can include but are not limited to hospitals, clinics, pharmacies, medical equipment suppliers, laboratories, home health agencies, and other healthcare providers.
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If you offer services or products that are supplementary to primary healthcare, becoming a Molina Healthcare ancillary provider may be beneficial for you.
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Molina Healthcare ancillary provider is a healthcare provider that offers supplemental services to Molina Healthcare members.
Healthcare providers who offer services to Molina Healthcare members are required to file Molina Healthcare ancillary provider.
To fill out Molina Healthcare ancillary provider, providers need to input specific information about the services rendered to Molina Healthcare members.
The purpose of Molina Healthcare ancillary provider is to track the additional services provided to Molina Healthcare members for billing and reporting purposes.
Providers must report details of the services provided, dates of service, billing codes, and any other relevant information required by Molina Healthcare.
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