How to Get Credentialed with Molina Healthcare in Ohio
Molina Healthcare in Ohio: by the numbers
Verified figures for this state, not national averages.
- Counties containing at least one member
- 38
- Distinct plans
- 1
- Counties with a plan offered
- 88
- Medicare Advantage service area
- offers Medicare Advantage plans in 88 of the 88 counties in this state that have any MA plan
- Largest counties by enrollment
- Franklin (5,024), Hamilton (2,932), Montgomery (1,159), Butler (998), Clermont (567)
- Medicare Advantage members in state
- 14,111
Source: CMS Monthly Enrollment by Contract/Plan/State/County (2026-07) · CMS Medicare Advantage Plan Landscape (CY2026) · Verified July 2026
Quick Overview
Timeline
60 - 90 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
Yes
How Molina Healthcare Credentialing Actually Works
Verified July 2026Apply Through
CAQH ProView into Molina's own credentialing process
Timeline
60 calendar days from a complete application, per Molina's own provider manuals
Recredentialing
Every 36 months
A complete credentialing application from CAQH ProView, or the state mandated application where one exists. Availity is operational only for Molina: eligibility, claims, EFT. A credentialing application submitted through Availity goes nowhere.
Behavioral health routing: Behavioral health is in house: BH clinicians join the same Molina credentialing pipeline as medical providers, with no vendor layer in between.
The stall to avoid: An active state Medicaid ID comes first (42 CFR 438.602). And in centralized credentialing states such as Ohio, the state credentials you, not Molina. Confirm the state's model before you promise a timeline.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
Ohio-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Ohio.
Complete Your CAQH ProView Profile
Molina Healthcare requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to Molina Healthcare. You can start the process at their enrollment portal.
Track & Follow Up
Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Molina Healthcare?
Our specialists handle the entire Molina Healthcare enrollment process: applications, follow-ups, and approvals in Ohio.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
5-year work history minimum; gaps > 6 months must be explained
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
3 peer references required
W9_FORM
Required for EFT/tax reporting setup
Enrollment Forms
Free Tools for Your Molina Healthcare Enrollment
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Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
- Provider Enrollment
- The process by which a healthcare provider applies to participate in an insurance payer's network, allowing the provider...
- Re-credentialing
- The periodic process, typically occurring every three years, in which a provider's credentials are re-verified to ensure...
Credentialing Checklist
Make sure you have everything ready before applying to Molina Healthcare.
View Physician Credentialing Checklist →Contact Information
Credentialing Email
National1-888-665-4621
submit@molinacredentialing.com
EDI Claims
National(866) 409-2935
EDI.Claims@MolinaHealthcare.com
EFT/ERA (ECHO Health)
National888-834-3511
edi@echohealthinc.com
Provider Contracting (NM)
National(855) 322-4078
NMProviderContracting@MolinaHealthcare.com
Provider Contracting (NV)
National(833) 685-2103
NVProviderContracting@MolinaHealthCare.Com
Mon-Fri 8am-6pm PST
Credentialing (WI)
National1-888-665-4621
WisconsinCredentialing@MolinaHealthcare.com
Quick Links
Molina Healthcare in Other States
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.