Welcome, Mississippi Healthcare Providers
Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.
As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.
If you have any questions, please call Provider Services at (844) 826-4335.
Need a Prior Authorization?
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
- Join Our Network
Would you like to become a Molina Medicaid provider? Visit our page called Join Our Network for step-by-step instructions.
The Claims Department is located at our corporate office in Long Beach, CA. All hard copy (CMS-1500, UB-04) claims must be submitted by mail to the address listed below. Electronically filed claims must use EDI Claims/ Payor ID number - 77010. You can also submit claims via our web portal. To verify the status of your claims, please call our Provider Claims Representatives at the numbers listed below.
Molina Healthcare of Mississippi, Inc.
PO BOX 22618
Long Beach, CA 90801
If your claims are mailed to our Jackson, MS office, they will be returned unprocessed.
- Appeals and Grievances
Appeals and Grievances
The Appeals and Grievances Department is located at our Jackson, MS office. If you chose to submit a written appeal and/or Grievance, it must be submitted by mail to the address listed below. Mailing
Molina Healthcare of Mississippi, Inc.
ATTN: Appeals and Grievance Department
188 E. Capitol St., Suite 700
Jackson, MS 39201
For providers seeking to appeal to denied Prior Authorization (PA) on behalf of a member only, fax Member Appeals at (844) 808-2407.
Pre-Service Appeal : (844) 808-2407
For providers seeking to appeal a denied claim only, fax Provider Claim Disputes/Appeals at (844) 808-2409.
If a provider rendered services without getting an approved PA first, providers must submit the claim and wait for a decision on the claim first before submitting a dispute/appeal to Molina.
Post Service Appeal: (844) 808-2409
For more information, refer to the Provider Manual.
- Retro-review authorization services rendered by providers during emergency operations that are impacted by a disaster area
Molina’s Utilization Management Department will allow retro-review authorization services rendered by providers during emergency operations that are impacted by a disaster area, as declared by the Governor of the State of Mississippi due to Hurricane Ida.
Please contact your Provider Services Representative if you have questions and/or need assistance.
Please note: When submitting a prior authorization for a service performed during disaster operations, please include the words RETRO and DISASTER AREA on the Prior Authorization request to help expedite the review of the case.
Please contact the Molina Utilization Department for any questions when submitting a retro Prior Authorization Form for a service provided during emergency operations.
- Molina Healthcare has chosen Availity as its exclusive provider portal
Effective 06/15/2021, Molina Healthcare of MS launched the new Availity provider portal. Providers will still have access to our legacy portal to allow time to get acclimated with our new Availity platform. However, we highly encourage any provider who has not registered with Availity to do so as soon as possible.
On Availity, providers will have access to:
• Submit claims, send supporting claim documentation, and check claim status.
• Verify member eligibility and benefits.
• View remittances and EOPs/EOBs.
• Access Molina-specific resources through a dedicated payer space on the Availity Portal:
o View and navigate through your member roster.
o Submit claim appeal/dispute/reconsideration.
o Compare your HEDIS scores with national benchmarks.
o Submit and view prior authorizations.
Please access this link to login or register: https://www.availity.com/molinahealthcare
For additional information, please contact your Provider Services Representative or Molina Provider Contact Center at (844) 826-4335.
- Molina Healthcare is happy to announce a partnership with ProgenyHealth LLC, a company that specializes in Neonatal Care Coordination Services.
Molina Healthcare of Mississippi is happy to announce a partnership with ProgenyHealth, a company which specializes in Neonatal Care Management Services throughout the first year of life. This is an exciting opportunity. ProgenyHealth’s care management program will enhance services to our members and support our mission to make a lasting difference in our members’ lives by improving their health and well-being.
Under the agreement that begins 7/1/2021,ProgenyHealth’s Neonatologists, Pediatricians and Neonatal Nurse Care Managers will work closely with Molina Healthcare of Mississippi members, as well as attending physicians and nurses, to promote healthy outcomes for Molina Healthcare of Mississippi premature and medically complex newborns.
The benefits of this partnership to you:
-The support of a team who understands the complexity and stress of managing infants in the NICU and will work with you to achieve the best possible outcomes
-A collaborative and proactive approach to care management that supports timely and safe discharge to home
- A company that believes in sharing best practices and works with NICUs nationwide to improve the health outcomes of our next generation
Families will have a dedicated case manager who will give support and education to members in the program. Also, they will be able to access an extensive online library and an “on-call” staff member available 24/7. For our hospitals, ProgenyHealth will serve as a liaison for Molina Healthcare providing inpatient review services and assisting with the discharge planning process to ensure a smooth transition to the home setting.
Your process for notifying Molina Healthcare of Mississippi of infants admitted to a NICU or special care nursery will remain the same. Molina Healthcare of Mississippi will notify ProgenyHealth of admissions and their clinical staff will contact your designated staff to perform utilization management and discharge planning throughout the inpatient stay.
If you wish to learn more about ProgenyHealth’s programs and services, call 1-888-832-2006 or visit progenyhealth.com.
Thank you for your partnership in caring for Molina Healthcare of Mississippi members.
Molina Healthcare and Progeny Health
It is important to Molina Healthcare and your patients that your provider directory demographics are accurate. Please visit our Provider Online Directory at: providersearch.molinahealthcare.com to validate your information and notify us if there are any updates.
Please notify Molina Healthcare at least 30 days in advance when you have any of the following:
- Change in office location,
office hours, phone, fax, or email
- Addition or closure of office location
- Addition or termination of a
- Change in Tax ID and/or NPI
- Open or close your practice to new
patients (PCPs only)