Molina Healthcare taps DME Navigator to streamline provider workflows

LONG BEACH, Calif. – Molina Healthcare of Illinois (MHIL) on March 2 announced the implementation of a new DME Navigator program for all lines of business effective June 1, 2026.

“DME Navigator is an end-to-end solution operated by Optum and CareCentrix leveraging the CareCentrix DME provider network,” the company stated in a memo. “Using a digital DME Navigator Point-of-Care (POC) platform powered by Parachute Health, it streamlines provider workflows and reimagines how members access their DME products and services.”

MHIL is rolling out the program in Illinois, Washington state, South Carolina and Ohio, with plans to expand to all 18 states, according to MAMES.

What DME providers need to know, according to MHIL’s memo:

• Molina is subcontracting the DME network to our delegate, Optum, for in-scope DME products and services.
• CareCentrix will contract, credential and manage a network of DME providers rendering in-scope products and services to Molina members.
• To provide Molina’s members with in-scope DME products, DME providers will need to be contracted directly with CareCentrix. If a provider chooses not to join the CareCentrix network, members receiving in-scope DME products and services will be transitioned to the CareCentrix network. Note: Your existing contract with Molina does not carry over to CareCentrix. To join the CareCentrix network, please contact DMEContracting@carecentrix.com.
• Orders for in-scope DME products and services for Molina members will be submitted through the DME Navigator POC Platform. Services should not be rendered until DME Navigator POC has approved you as the servicing DME provider. Services not provided according to the DME Navigator POC process are ineligible for reimbursement.
• After being selected to be the rendering provider by DME Navigator POC, authorizations for in-scope DME products and services will still be submitted through the standard submission process to Molina. At a future date (to be announced), Molina will transition authorizations of in-scope DME products and services to the DME Navigator program.
• After rendering the approved services, claims for DME products and services will be submitted through the standard submission process and adjudicated by Molina. Reimbursement eligibility is dependent on your agreement with CareCentrix and is subject to applicable state, federal, and coding guidelines.
• Continuity and transition of care will be managed by CareCentrix for in-scope services.

For a list of in-scope products and services, go here.

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