MedicaidAdministrativeMedium impact
01-08-2026 Billing Reminder: Skilled Nursing Facilities, ICF-DD, and Subacute Care Facilities IM IE LA SAC SD
Molina Healthcare·CA·Claims & Billing
Effective date
Jan 8, 2026
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California issued a billing reminder for Skilled Nursing Facilities, ICF-DD, and Subacute Care Facilities to reduce common claim denials. The policy highlights four main denial reasons: duplicate services, missing authorization, enrollment discrepancies, and invalid revenue codes, with specific recommendations to prevent each type of denial.
Action Required
Immediately: Billing team must implement pre-submission checks for all Molina SNF, ICF-DD, and subacute claims: 1) Verify member eligibility before service and claim submission via availity.com/molinahealthcare/, 2) Check original claim status before submitting any duplicate claims, 3) Obtain and include authorization numbers for all services requiring prior auth, 4) Validate revenue codes against current billing guidelines and payer-specific manuals before submission. Update billing workflows to include these verification steps to prevent denials and payment delays.