MedicaidAdministrativeMedium impact
Provider Bulletin 07-17-2025 SNF ICF Developmental Disabilities and Subacute Care Facilities Billing Reminder IM IE LA SAC SD
Molina Healthcare·CA·Claims & Billing
Effective date
Jul 17, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California issued a billing reminder for SNFs, ICF/DD, and subacute care facilities highlighting four common claim denial reasons: duplicate services, missing authorization, enrollment discrepancies, and invalid revenue codes. Providers must verify authorizations, check member eligibility, avoid duplicate billing, and ensure proper revenue code alignment to prevent denials.
Action Required
Immediately: Billing team must implement pre-submission checks for all SNF, ICF/DD, and subacute facility claims to verify member eligibility, confirm authorization numbers are included on claims, check for duplicate services through claim status inquiries, and validate revenue codes align with services rendered using current billing guidelines. Update billing workflows to include these verification steps to prevent claim denials and payment delays.