MHO Claim Reconsideration Form

MHO, Claim, Reconsideration, Form

Molina Healthcare

MHO Claim Reconsideration Form - Molina Healthcare

Please refer to the Molina Provider Manual for timeframes and more information. Appeals related to Authorizations should be submitted using the Authorization Reconsideration Form. Corrected Claims Please send corrected claims as a normal claim submission electronically or via the . Provider Portal. Multiple Claims

MHO Claim Reconsideration Form
Claim Reconsideration Request Form

Date: __/__/____

 Please submit the request by visiting our Provider Portal, or fax to (800) 499-3406.
  Attach all required supporting documentation.
  Incomplete forms will not be processed. Forms will be returned to the submitter.
  Please refer to the Molina Provider Manual for timeframes and more information.
  Appeals related to Authorizations should be submitted using the Authorization Reconsideration Form.


Corrected Claims
 Please send corrected claims as a normal claim submission electronically or via the Provider Portal.

Multiple Claims If multiple claims with the same denial require an appeal, attach an Excel sheet.
 Note: Multiple claims must be from the same rendering provider and for same claim denial reason.


Contact Person Provider/Group Name Provider NPI Provider Phone #

Provider Information
Contact Phone #
Provider Tax ID/Medicare ID Provider Fax #

Member Name Member Date of Birth

Member Information
Member Account # Molina Member ID

Line of Business Claim Information Molina Original Claim ID Original Claim Amount Billed Dates of Service

Claim Information

 Medicaid

 Marketplace

 Medicare

 MMP

 Single Claim

 Multiple Claims

 LTSS

Denial Reason (Mark all applicable)

 Duplicate Service  Processed under incorrect Provider/Tax ID  Overpayment/Underpayment  Exceeded timely filing limit  Missing/Incorrect NDC

 Coordination of Benefits (COB)  Processed under incorrect member  National Correct Coding Initiative (NCCI) Edit  Eligibility  Other (Please explain)

Additional Information:

MHO-0779 0119


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