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MOLINA VALUE ADDED SERVICE AUTHORIZATION REQUEST FORM SECTION I SUBMISSION Issuer Name: Phone: Molina Healthcare of Texas Utilization Management: 8553224080Fax: 8443047127Date:SECTION II GENERAL INFORMATION

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What is molina value added service?

Molina Value Added Service refers to additional healthcare services provided by Molina Healthcare to enhance patient care, improve health outcomes, and support members beyond standard healthcare offerings.

Who is required to file molina value added service?

Providers and organizations that participate in Molina Healthcare's programs and receive reimbursement for value added services are typically required to file Molina Value Added Service documentation.

How to fill out molina value added service?

To fill out the Molina Value Added Service documentation, providers should gather all relevant patient information, service details, and adhere to the specific reporting guidelines provided by Molina Healthcare.

What is the purpose of molina value added service?

The purpose of Molina Value Added Service is to offer enhanced support and resources for members, facilitate improved health outcomes, and help address social determinants of health.

What information must be reported on molina value added service?

Information that must be reported on Molina Value Added Service includes patient demographics, service provided, dates of service, outcomes achieved, and any other relevant data as specified by Molina Healthcare guidelines.

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