Summary
Molina Healthcare of Utah released a Q2 2026 provider newsletter containing multiple operational updates. Key billing-related changes include: (1) New EFT/ERA enrollment through ECHO Health with SSI Group, offering virtual card, ACH, check, or EFT payment options; (2) Launch of Molina Care Connections with nurse practitioner-delivered services at $0 member cost across 22 states; (3) Clarification of utilization management criteria and decision-making processes. The practice must update systems to accept SSI Group payer ID for ERAs and coordinate with Molina Care Connections to avoid duplicate billing.
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What to do
Action · 18 steps
01REQUIREMENTS:
1. Billing System Update (Immediate): Update practice management system to recognize and process ERAs from SSI Group using the Molina payer ID.
02Configure system to accept ERA data from providerpayments.com portal.
032. EFT Enrollment (Within 30 days): Billing team must enroll in ECHO Health EFT/ERA services through SSI Group (no cost).
04Visit providerpayments.com.
05Complete enrollment form.
06Specify payment preference (ACH, EFT, check) before first payment to avoid default virtual card payments which may carry merchant fees.
07Contact ECHO Customer Service at (888) 834-3511 or edi@echohealthinc.com if virtual card opt-out needed.
083. Care Connections Coordination (Immediately): Establish internal process to identify Molina members eligible for Care Connections services (homebound, uncontrolled chronic conditions, frequent ED visits, recent hospital discharge, unmet SDOH needs).
09Do NOT bill for duplicate services when Care Connections NP provides care at $0 member cost.
10Train billing staff that Care Connections visits are non-billable to practice.
11Access visit records via EpicCare Link (CCLink.MolinaHealthcare.com) for care coordination.
124. UM Documentation (Ongoing): Ensure providers document clinical appropriateness for all referrals per MCG, ASAM, NCCN, Hayes, and Molina Clinical Policy criteria.
13Providers can access MCG Cite for Care Guideline Transparency tool via Availity Essentials.
14Call UM department at (844) 826-4335 with questions.
15Expect written notification of all UM denials.
165. Consequences: Failure to update EFT/ERA systems will result in delayed/unprocessed remittance advice.
17Billing Care Connections services will result in claim denials.
18Non-compliance with UM criteria may increase authorization denials.
Original notice
Second Quarter 2026
molinahealthcare.com · Always check the source before changing claims.