Contact Information
Phone Numbers
Fax Numbers
For a full list of provider contact information, please reference the Provider Quick Reference Guide.
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VendorsCVS/Caremark – Pharmacy
Telephone:
Prior Auths, Inquiries: (877) 872-4716 Retail Drugs only: (800) 364-6331 Fax: (844) 823-5479 Claims/Payment issues: (262) 241-7379
All other: (262) 834-3589
Emails: Claims: denclaims@dentaquest.com Eligibility/Benefits: denelig.benefits@dentaquest.com Mailing Address: DentaQuest IPA of New York LLC -
ATTN: Claims or UM/Appeals (same address for both)
PO Box 2906
Milwaukee, WI 53201-2906
Superior Vision / Versant Health –Vision Services Telephone: (866) 819-4298 PAYER ID: 41352 Paper Claims |
Claims Department
The Claims Department is located at our corporate office in Long Beach, CA. All hard copy (CMS-1500, UB-04) claims must be submitted by mail to the address listed below. Electronically filed claims must use EDI Claims/Payor ID number - 16146. To verify the status of your claims, please call our Provider Claims Representatives at the numbers listed below.
| Claims | |
| Address | Molina Healthcare of New York, Inc. PO BOX 22615 Long Beach, CA 90801 |
| Phone: | (877) 872-4716 |
For more information, refer to the Provider Manual.
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Claim Disputes/Reconsiderations
Providers disputing a Claim previously adjudicated must request such action within 90 days of Molina’s original remittance advice date. Regardless of type of denial/dispute (service denied, incorrect payment, administrative, etc.); all written Claim disputes must be submitted on the Molina Provider Appeal Form found on Provider website and the Provider Portal. The form must be filled out completely in order to be processed. Additionally, the item(s) being resubmitted should be clearly marked as a Claim Payment Dispute and must include the following:
Submission Process:
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