MedicaidAdministrativeMedium impact
Provider Bulletin 11-14-2025 Skilled Nursing Facilities, Intermediate Care Facilities for Individuals with Developmental Disabilities and Subacute Care Facilities Billing Reminder IE LA SAC SD
Molina Healthcare·CA·Claims & Billing
Effective date
Nov 14, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California issued a billing reminder for skilled nursing facilities, intermediate care facilities for developmental disabilities, and subacute care facilities to reduce common claim denials. The bulletin identifies four main denial reasons and provides specific recommendations to prevent them, including verifying authorization requirements, checking member eligibility, avoiding duplicate claims, and using correct revenue codes.
Action Required
Immediately: Billing teams at SNFs, ICF/DD facilities, and subacute care facilities must implement best practices to reduce denials: 1) Check claim status via inquiry before submitting duplicate claims, 2) Verify authorization requirements and include authorization numbers on all claims requiring them, 3) Verify member eligibility before service delivery and claim submission using Molina's provider portal at availity.com/molinahealthcare/, 4) Validate revenue codes align with services rendered using authoritative coding resources. Reference the facility-specific toolkits provided for additional guidance.