MedicaidAdministrativeMedium impact
Provider Bulletin 05-01-2025 Provider Explanation of Payment / 835 Enhancement IM IE LA OC SAC SD
Molina Healthcare·CA·Claims & Billing
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California changed how refund postings appear on Provider Explanation of Payment (EOP) and 835 remittance files. Instead of using Molina's internal claim ID, refunds will now reference the patient control number from your original claim submission, making reconciliation easier for billing teams.
Action Required
Immediately: Billing team should update reconciliation processes to expect patient control numbers instead of Molina internal claim IDs when processing refund postings on EOP and 835 files. Train staff on the new format and note that patient control numbers over 14 characters may have truncated Check History IDs on PDF EOPs (but full data remains in 835 files).