Oakland Southfield Physicians

OSP News

Molina Releases Helpful Information for Claim Disputes

Posted: 07/13/2020

Molina strives for timely and accurate claims payment, applying state and national coding standards and requirements. Over this past year, based on feedback from providers from the 2019 provider satisfaction survey, Molina has improved its Claims Dispute Process when you believe a claim has not been paid correctly.

Here are some tips to dispute a claim and receive a prompt response:

  • File your dispute within 90 days of claims payment.
  • Use the Claims Dispute Request form.
  • Upload to the Molina Provider Portal or fax to (248) 925-1768.
  • Molina will respond within 45 days for Medicaid/Marketplace and 60 days for Medicare. Recent statistics show:
    • Molina is averaging 98% of claims disputes complete within the given timeframe across all lines of business.
    • In some cases, Molina is exceeding the standard turnaround time for review of claims disputes, particularly in the Medicaid line of business.

Click here to read the full announcement. To view a helpful claims appeal guide click here

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