Provider Self Services

Admin User Responsibility

Before creating your account, please note that you will be responsible for the following:

• Managing all additional users added to the account which includes:
  - Inviting New Users
  - Assigning User Roles
  - De-Linking Users
  - Linking Users Accounts as needed

• Perform mandatory periodic reviews validating the list of Users remains accurate
To continue with registration,click here
To exit click here
For more information about Molina's Provider Self-Services ePortal, visit the FAQs section

Format:

Please select a Export Option

Check the information to be displayed in the report :

Select All

Member ID
Last Name
First Name
Middle Name
Gender
Date of Birth
Language
Physical Address
Physical City
Physical County
Physical State
Physical Zip Code
Phone Number
Program Name
Enrollment Effective Date
Enrollment Term Date
Enrollment Restriction
Rate Code
Other Coverage
PCP Name
Oldest PCP Effective Date
PCP Term Date
Pay To Name
Pay to Address
Prior PCP

Please select a Column to Export

Would you like to save your export selection as default?

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Effective 01/01/2020:
Some services will be handled by eviCore.
Please verify codes prior to submitting a
Service request/authorization.
You can find the Current PA Code Guide here
eviCore Website