Coverage profile
Work Molina Healthcare Illinois across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Molina Healthcare Illinois.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Molina Healthcare Illinois.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Molina Healthcare Illinois.
Other aliases
Also known as
- 10685
- 20934
- 6806
- 6907
- MLNIL
- MOLIL
- MOLINA_IL
- MOLINAIL
Payer policies
Molina Healthcare Illinois policies
The first 25 of 683 public policies Substrate tracks for Molina Healthcare Illinois, by title. Links open the payer's own document; check its current version before relying on it.
- 001 CPT and Place of Service Invalid CombinationView PDF ↗
- 002 Critical Care Billed Same Day as Emergency Room ServicesView PDF ↗
- 003 New Patient Visits Incorrect CodingView PDF ↗
- 004 Global Surgery PeriodView PDF ↗
- 005 Medical Management versus PsychotherapyView PDF ↗
- 006 Evaluation & Management Services with Injection(s) and Infusion ServicesView PDF ↗
- 007 Not Otherwise Specified CodesView PDF ↗
- 008 CPT HCPCS and Modifier CombinationView PDF ↗
- 009 Overlapping Room and Board plus Other Institutional ServicesView PDF ↗
- 010 Overlapping Room and BoardView PDF ↗
- 011 ESRD Bundling End-Stage Renal DiseaseView PDF ↗
- 012 Bundling Pre-Dialysis UltrafiltrationView PDF ↗
- 013 E&M Services Billed With Revenue Code 0761View PDF ↗
- 014 Self-Administered DrugsView PDF ↗
- 015 Always Therapy CodesView PDF ↗
- 016 Claim Condition Codes D and RView PDF ↗
- 017 Claims With Incarceration Diagnosis CodeView PDF ↗
- 018 CPAP and BiPAP Compliance With Month Four and BeyondView PDF ↗
- 019 Definitive Drug Testing Yearly Same Day LimitView PDF ↗
- 020 Device Dependent Procedure Without Device Billed On ClaimView PDF ↗
- 021 Direct IP Admit from ER Condition Code P7View PDF ↗
- 022 DME Air Fluidized Mattress Missing Qualifying Diagnosis CodeView PDF ↗
- 023 Hospice Overlapping With Room and BoardView PDF ↗
- 024 Injections and Infusions Billed With ERView PDF ↗
- 025 Labs Overlapping With FacilityView PDF ↗
Search all 683 Molina Healthcare Illinois policies by CPT code, keyword or policy number →
Routing reference
Molina Healthcare Illinois payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Molina Healthcare IllinoisSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | ILSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 20934Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 20934Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 20934Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 20934Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | MLNILSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 20934Source: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Molina Healthcare Illinois. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: MOLINA HEALTHCARE ILLINOIS. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Molina Healthcare Illinois. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Phone and fax contacts
Numbers vary by plan, service, and department. Check the member’s ID card before calling or sending a fax.
Phone numbers5
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 541-2767 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 777-6000 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 734-8543 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 842-3210 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 874-9378 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
Numbers stated in payer eligibility responses; scope may depend on benefits, products, or departments.