The Health Delivery Organization (HDO) Application, as set forth by Molina Healthcare, Inc., is a comprehensive document required for both initial credentialing and recredentialing of healthcare facilities or organizations seeking to establish or renew contracts with Molina Healthcare. The instructions within the application outline a meticulous process that includes the submission of the fully completed form alongside necessary attachments. These prerequisites include current organizational or facility licenses, certifications, or registrations, proof of CMS participation if applicable, the latest liability insurance face sheet, and W9 forms to verify federal Tax Identification Numbers. The application distinguishes between facilities with multiple locations, prescribing separate forms for each location subject to independent state, CMS, or accreditation surveys, while a single application suffices for organizations operating under a cohesive survey across all locations. Furthermore, the application mandates the thorough completion of all sections unless explicitly marked as inapplicable, prohibiting any form of alteration such as the use of white-out. Additionally, accreditation documentation or the most recent CMS or state survey results are requested for non-accredited organizations mandated for certification. The insistence on completeness underscores a preliminary review process, with any deficiencies resulting in the return of the application for completion before processing can proceed. As an integral step towards joining Molina Healthcare's network, the application not only facilitates the credentialing process but also emphasizes compliance with federal and state regulations, including accessibility standards and routine background checks for healthcare-associated employment. The document concludes with an attestation and release of information form, cementing the applicant's commitment to accuracy, compliance, and cooperation with Molina Healthcare's policies and quality standards.
| Question | Answer |
|---|---|
| Form Name | Hdo Application |
| Form Length | 5 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 15 sec |
| Other names | molina healthcare health delivery organization application, molina healthcare provider application, application molina accreditation, hdo ohio application |
