(614)355-5560
South Central / Southeast Region
November 30, 2022
December Managed Care Plan Updates

This past month, CareSource and Molina have published updates on events and policy changes impacting their organizations.

CareSource Updates

  • Provider Alternative Format Request: Providers can now see whether their CareSource members have requested an alternate format for communications when they check the member’s eligibility. This information can be found on the Provider Portal under the member eligibility screen. Alternative format options include braille, sign, large print, audio CD or verbal. If no alternative format has been requested, the field will be blank. Click here to view the full update.

Molina Updates

  • Claims Processing Update – Modifiers: Effective December 1, 2022, Molina is adding some claims processing enhancements. The enhancements will address coding situations that are complex and cannot auto-adjudicate and some of the new edits support the correct use of modifiers.  Click here and scroll to page 7 to view which modifiers will be enhanced.
  • Claim Submission – Electronic and Paper: Effective January 1, 2023, Molina will no longer accept claims submitted via non approved submission pathways. Molina accepts claims electronically via clearinghouse and through the Provider Portal. Molina also accepts paper claims on original (red colored) CMS-1500 and 1450 (UB-04) claim forms sent to the Molina Claims PO Box. Click here and scroll to page 3 to view the full update and approved ways to submit a claim.
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