Molina Healthcare of Nebraska Provider Claims Testing

FAQ

Molina Healthcare of Nebraska Provider Claims Testing

We want to extend a warm welcome and thank you for agreeing to participate in the Molina Healthcare of Nebraska Provider Claims Testing. The purpose of the claims testing is to support a smooth implementation and alleviate provider burden.

The high-level timeline is as follows

  • 8/11/2023 – Test members and claims date of service range to be used distributed
  • 9/5/2023 – Molina is ready to accept test claims
  • 9/12/2023 – 12/12/2023 – Results and Q&A sessions

Molina Healthcare of Nebraska has selected The SSI Group, LLC (SSI) as the exclusive Electronic Data Interchange (EDI) gateway clearinghouse. SSI will be Molina’s front-end clearinghouse for claims and other EDI transactions. However, providers may continue to submit claims through existing clearinghouse arrangements. Those clearinghouse vendors will automatically transmit Molina Healthcare of Nebraska claims to SSI for processing.

How to Submit a Test Claim

To deliver providers the best possible service, Molina Healthcare of Nebraska and SSI will open a test window from September 5, 2023, through December 1, 2023, to allow providers to test their medical claims submissions. All providers who wish to test during this time should complete the following steps by November 15, 2023. Please note the Molina Healthcare of Nebraska assigned Health Plan Payer ID is MLNNE.

Step 1 Complete and Submit the Request to Test Form

Step 2: Review the Submitter Testing Guide

This Submitter Testing Guide will walk you through the process of submitting claims.

Step 3: Test Claims Submission

Providers can test via the web portal. It is the most direct and transparent method. Not only can providers submit test claims through the portal, but they will also be able to track the claim process and receive acknowledgments. There is no charge to providers for testing through the portal. If you prefer to test through your existing clearinghouse, please contact your clearinghouse, and they will schedule a time to test with SSI.

If you have any questions, you can also reach the SSI EDI team via email at SubmitterTestSupport@ssigroup.com or by calling 800-820-4774. Telephone support is available 8:00am to 4:00pm CST.

If you are a clearinghouse and want to test via SFTP,  please complete the form below.

Clearinghouse Submitters Only

12 + 1 =

Frequently Asked Questions

Will the Claims process in production as they will processing during testing?

Molina is making every effort to ensure testing is production-like as possible but please keep in mind that since we are still configuring the solution for Nebraska, there may be items that are not yet in place. We will discuss specific items during the results and Q&A sessions.

Can I submit production claims for the testing?
We would prefer to not have PHI exchanged during the testing. We assume some providers will take production claims and de-identify the information to remove PHI. If you have test members that you already use in your environment, please let us know and we may be able to load them into our test environment to facilitate the claims creation.

In addition to the information above, your Provider Services Representative (PSR) is available to meet with your office staff and to respond to any questions you may have. If you would like to schedule a meeting with your PSR or have any questions, please send an email to NEProviderRelations@MolinaHealthcare.com

What transactions will be accepted for testing?
  • 837I (Institutional Claim)
  • 837P (Professional Claim)