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New Accounts - Provider | Member

MOlina MMP Medicare - Medicaid

Molina Dual Options Medicare- Medicaid Plan

Effective March 1, 2014, Avesis Third Party Administrators, Inc. will be administering dental benefits to Molina Dual Options Medicare-Medicaid Members in the following Illinois counties: Stark, Champaign, Christian, DeWitt, Ford, Knox, Logan, Macon, McLean, Menard, Peoria, Piatt, Sangamon, Tazwell, and Vermillion.

Effective April 1, 2014, Avesis Third Party Administrators, Inc will be administering dental benefits to Molina Dual Options Medicare-Medicaid Members in the following counties in California: Riverside, San Diego, and San Bernardino.

Below you will find a sample image of the ID card

Molina IL Dual Options Medicare-Medicaid Plan

 

Molina CA Dual Options Cal MediConnect Plan

Members' benefits vary according to their individual coverage. As a participating provider, it is imperative that you verify eligibility and benefits on all members each time that they present in your office. Please remember that only the services covered by the member's benefit plan will be paid by Avesis. Please contact an Avesis Provider Service Representative at 855-704-0433 for detailed information on the benefit plan for the Molina Dual Options Medicare-Medicaid Plan members. Please remember that only the services covered by the member's benefit plan will be paid by Avesis.

Molina Illinois Dual Options MMP- Plan benefits include preventive services such as exams, cleanings, and x-rays. Plan benefits also include comprehensive services which include a $1000 Annual Maximum. Treatment plans over $500 require prior authorization.

Molina California Dual Options MMP- Plan benefits include preventive services such as exams, cleanings, and x-rays. Plan benefits also include comprehensive services. Treatment plans over $500 require prior authorization.

If you are not currently an Avesis contracted provider and are interested in participating in these programs, please complete the Provider Credentialing and Contracting paperwork. Please note that Avesis participates with CAQH. If you have a CAQH number, please be sure that your credentials and attestation are current. Please make sure that you have selected “Global” for Avesis to receive your information. Once everything is current you may provide us with your CAQH number and exact name as it is on the CAQH. If you do not have a CAQH number, please contact us to assist you in obtaining one.

All participating providers must have a NPI number. If you do not have a NPI number, please click here to apply. If you have any questions please contact one of our Provider Services Representatives at 855-704-0433.

Send Completed Materials by mail to Provider Services:

Mail To:

Avesis Third Party Administrators, Inc.
10324 Soulth Dolfield Road
Owings Mills, MD 21117