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MOLINA HEALTHCARE MEDICAID PRIOR AUTHORIZATION/PRESERVICE REVIEW GUIDE EFFECTIVE: 01/01/2021 REFER TO MOLINA PROVIDER WEBSITE OR PRIOR AUTHORIZATION LOOKUP TOOL/MATRIX FOR SPECIFIC CODES THAT REQUIRE

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How to fill out molina medicaid prior authorization

01

Contact your healthcare provider and ask if a prior authorization is required for the specific service or medication.

02

Get the necessary prior authorization form from Molina Medicaid or your healthcare provider.

03

Fill out the form completely and accurately, including all required information such as your name, Medicaid ID, provider information, service or medication requested, and any supporting documentation.

04

Submit the form to Molina Medicaid through the designated method, such as online portal, fax, or mail.

05

Wait for a decision on the prior authorization request from Molina Medicaid, which typically takes a few business days.

Who needs molina medicaid prior authorization?

01

Anyone who is covered by Molina Medicaid and requires a service or medication that requires prior authorization.

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What is Molina Medicaid prior authorization?

Molina Medicaid prior authorization is a process that requires healthcare providers to obtain approval from Molina Healthcare before providing certain medical services, medications, or procedures to ensure they are covered under the Medicaid plan.

Who is required to file Molina Medicaid prior authorization?

Healthcare providers, including doctors and specialists, who wish to provide specific services or medications that require prior authorization are required to file Molina Medicaid prior authorization.

How to fill out Molina Medicaid prior authorization?

To fill out Molina Medicaid prior authorization, providers must complete a designated prior authorization form, including details about the patient, the requested service or medication, clinical rationale, and any supporting documentation needed to justify the request.

What is the purpose of Molina Medicaid prior authorization?

The purpose of Molina Medicaid prior authorization is to ensure that medical services and prescriptions are medically necessary, appropriate, and cost-effective, thereby helping manage healthcare costs and resources.

What information must be reported on Molina Medicaid prior authorization?

Information that must be reported includes patient identification details, the specific service or medication requested, diagnosis codes, clinical notes, and any relevant documentation that supports the necessity of the request.

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