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Get Molina Healthcare Hdo Application 2014
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How to fill out the Molina Healthcare HDO Application online
Completing the Molina Healthcare Health Delivery Organization (HDO) Application online is a straightforward process. This guide will provide you with step-by-step instructions to ensure you fill out the application accurately and completely.
Follow the steps to successfully complete your application.
- Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
- Fill in the organization information. Ensure to provide the legal name, DBA name (if applicable), and contact details such as address and phone number. It's essential that this section reflects the official records of your organization.
- Provide current insurance coverage details. If you have professional liability insurance, fill in the policy number, policy type, and coverage amounts. If your facility is not required to carry liability insurance, check the appropriate box.
- Complete the physical location information for each practice location. Each location should have its information entered, including whether it is Medicare certified, accessibility features, and any additional credentials required.
- Indicate the primary contracted specialty and taxonomy codes. If more than one specialty is needed for different locations, ensure that separate full applications are submitted for each location.
- Fill in the accreditation and certification details, checking all applicable organizations. If not accredited, specify if the State conducts routine surveys.
- Go through the credentialing program section, answering various questions regarding the processes in place for verifying licenses, ensuring renewals, and conducting background checks.
- Complete the attestation and release of information section, ensuring the authorized agent provides their signature and printed name along with the date.
- Review all filled sections to ensure completeness and accuracy. After confirming, save changes, download the application, print it as needed, or share it with designated representatives.
Start completing your Molina Healthcare HDO Application online today!
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The process for Molina prior authorization can vary, usually taking a few business days. It largely depends on the complexity of the request and the specific service. By staying engaged with the Molina Healthcare HDO Application, you can receive timely updates on the status of your authorization, ensuring you are kept in the loop.
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