Molina Complete Care
Welcome to the Molina Complete Care Health Plan page. Here you can download policies and procedures specific to both ordering and rendering providers. These include quick reference guides and information designed to assist you in using RadMD to request and check the status of prior authorizations.
If you have any questions about our programs, please contact your dedicated NIA Provider Relations Manager, Lori Fink.
Advanced Imaging Program
- Quick Reference Guide
- Frequently Asked Questions
- Provider Training Powerpoint-Medical Specialty Solutions
- Tip Sheet-Top procedures ordered through Magellan HealthCare
- Prior Authorization Checklist
- Cardiac Tip Sheet
- Cardiac Checklists
- Tip Sheet for MPI vs SE
- Transthoracic Echocardiography Tip Sheet
- Cardiac Imaging Provider Frequently Asked Questions
Radiation Oncology Benefits Management
Radiation Oncology Checklists
- Anal Cancer
- Bone Metastatic Cancer
- Bone Primary Cancer
- Breast Cancer
- Central Nervous System (CNS) Metastatic Cancer
- Central Nervous System (CNS) Primary Cancer
- Cervical Cancer
- Colon Cancer
- Endometrial Cancer
- Gastric Cancer
- Head and Neck Cancer
- Hodgkins Lymphoma
- Lung Cancer (Non-Small Cell)
- Lung Cancer (Small Cell)
- Non-Hodgkins Lymphoma
- Other Cancer
- Other Metastatic Cancer
- Pancreas Cancer
- Prophylactic Cranial Irradiation
- Prostate Cancer
- Rectal Cancer
- Skin Cancer
Radiation Oncology Benefits Management Educational Documents
- Radiation Therapy Treatment Notification Form for Transition Cases
- Radiation Oncology Quick Reference Guide
- Radiation Oncology Frequently Asked Questions
- Radiation Oncology Provider Education Training
Musculoskeletal (MSK) Management Program Documents
- Spine Pain Management Quick Reference Guide for Ordering Physicians/Surgeons
- Interventional Pain Management Checklist
- MSK Provider Education Training
- MSK Frequently Asked Questions
- Spine Surgery Checklist
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD is a user-friendly, real-time tool offered by Magellan Healthcare that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource.
Search for resources by program:
Recorded General Trainings
We have a series of training videos that discuss the components of requesting a prior authorization request. Click here to access these videos.
Recorded RadMD Demos
Need additional help using RadMD? Click here to access a series of RadMD demos that demonstrate how to properly submit a prior authorization request.
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Magellan Healthcare
Clinical Training Modules
We have a series of clinical training modules that will help you avoid delays and ensure that you have the right information before submitting your prior authorization request. Click here to access them.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).