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Molina Healthcare Medicaid Prior Authorization/PreService Review Guide Effective: 01/01/2021Refer to Molina's Provider website or Prior Authorization Lookup Tool/ Matrix for specific codes that require

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How to fill out refer to molinas provider

01

To fill out a referral to Molinas provider, follow these steps:

02

Obtain the referral form from your primary care physician or healthcare provider.

03

Fill in your personal information, including your name, date of birth, and contact details.

04

Provide details about your primary care physician or referring healthcare provider.

05

Include information about the specialist or Molinas provider you are referring to. This may include their name, contact information, and specialty.

06

Describe the reason for the referral and any specific concerns or symptoms you have.

07

Attach any relevant medical documents or test results that support the need for the referral.

08

Verify the referral form for accuracy and completeness before submitting it.

09

Submit the referral form to your primary care physician or healthcare provider, who will then process it and send it to Molinas provider.

Who needs refer to molinas provider?

01

Anyone who requires specialized medical care or consultation from a Molinas provider may need to refer to them. This can include individuals with specific medical conditions, chronic illnesses, or complex health issues that require the expertise of a specialist. Additionally, individuals who have received a recommendation for a specific Molinas provider from their primary care physician or healthcare provider may also need to refer to them.

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Refer to Molinas provider means to consult or ask for information from Molinas provider.

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Anyone who needs information or data from Molinas provider may be required to file a request.

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To fill out a refer to Molinas provider, you may need to provide specific details or information requested by the provider.

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The purpose of refer to Molinas provider is to obtain relevant information or data from the provider.

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