Provider Resources & Forms
In need of a form, have a question or need more information on a topic, choose from the resources below. If you can't find what you are looking for or need more help, don't hesitate to email us at firstname.lastname@example.org.
Credentialed Ancillary Facility Data Form
Data Forms for Physician Groups
Demographic Change Form
HIV Attestation Form 2020
Non-Credentialed Practicioner Application
Practitioner Enrollment Application
Group Medical Visit Toolkit for Diabetes Care
Molina Provider Portal
If you have not already done so, sign up for Molina’s Provider portal to check member eligibility, claims status, PCP rosters and more at your fingertips. Please follow the instructions in this document to register for portal access.
Electronic Funds Transfer - Timely and Efficient Payment
Sign up for EFT to make the best use of your time and resources. Please follow the instructions in this document to register for EFT payments.
LINKS to Molina Healthcare of New York Resources
Molina Member Incentives