PCP Member Dismissal Form
PCP Member Dismissal Form
Prior Authorization Forms and Codification Matrix
Prior Authorization Guide/Authorization Form
Prior Authorization Form Private Duty/Attendant Nursing Care
J-Code Prior Authorization Form
Appeals and Grievances
Provider Appeal/Dispute Form
Member Grievance Form
Referral Forms
Disease Management Form
Provider Contracting and Credentialing Forms
Health Delivery Organization (HDO) Form
W-9
FL PCP Patient Capacity Attestation
Telehealth Attestation
Telehealth/Telemedicine Attestation
Provider Information Change Form
Provider Information Change Form
Pregnancy Forms
Statewide Pregnancy Notification Form
Healthy Start Prenatal Screener Form
Claims and Billing Codes
In-Office Labs List
Child Health Check-Up Billing and Referral Codes
Molina Provider Claims Project Request Log
Critical Incident Form
Critical Incident Form
Serious Adverse Event Reporting Form
Sterilization Consent
Sterilization Consent Form
CMS-0057 Prior Authorization Annual Reporting
2025 Prior Authorization Guide
Prior Authorization Lookup Tool
Florida Medicaid Prior Authorization Annual Report 2025
| Prior Authorization Statistics |
Molina Healthcare Inc
Percentage
|
| The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. |
85% |
| The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. |
15% |
| The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. |
33% |
| The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. |
43% |
| The percentage of STANDARD prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
53% |
| The percentage of EXPEDITED prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
67% |
| The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. |
94% |
| The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. |
6% |
|
Timing |
| Average time that elapsed between the submission of a request and a determination by the payor, plan or issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
2 |
| Median time that elapsed between the submission of a request and a determination by the payor, plan, issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
1 |
| Average time that elapsed between the submission of a request and a decision by the payor, plan or issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
12 |
| Median time that elapsed between the submission of a request and a decision by the payor, plan, issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
5 |
|
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