Credentialing with Molina Before October 1: What to Check
Part of our guide to the CMS Plan transition. Jessie Solognier, COO of Edwards Electronic Processing (EEP), on the one step with a hard deadline and the paperwork detail worth reading closely before signing.
What’s happening
When Molina takes over Florida’s CMS Plan on October 1, 2026, existing Sunshine Health contracts do not automatically transfer. That catches a lot of clinics off guard. Credentialing and contracting with Molina is a separate process, and it sits with the clinic.
The continuity-of-care (COC) rules soften the edge. AHCA’s guidance protects rates for providers not yet in network for a period, so a clinic still working through paperwork shouldn’t be stranded. This provides a cushion. For the specifics, see our guide to the CMS Plan move to Molina.
What we know
What doesn’t transfer: Your Sunshine Health contract. Credentialing with Molina is a new process.
What the cushion covers: Rate protection for non-participating providers during the continuity-of-care period. See the transition overview for the specifics.
What often rides along: Electronic funds transfer enrollment is frequently handled during credentialing. This is worth confirming for your clinic rather than assuming.
What to read closely: The fee schedule attached to any new contract.
The interview
Where will clinics face the initial challenges with this transition?
Credentialing. Clients are specifically asking whether anyone has received a signed contract back from Molina yet. As of early August, I have not heard of many contracts signed, and that’s not what I’d want this close to October 1. What softens it is that continuity-of-care rules generally require the plan to cover out-of-network providers for a period, so it should be workable even with delays. Still, it’s the item I’d move to the top of the list to stay aware of. It’s really important you start this as soon as possible if you haven’t already. I have read some ABA clinics being turned away, indicating the network is at capacity for that region. In those cases, COC will still be honored, but the provider will be left out once the COC provisions end.
For a clinic already contracted with Sunshine, what does starting over with Molina involve?
Everything runs through Molina’s provider portal. You submit a contract request there, and you fill in credentialing information in Molina’s system as part of the same process. It isn’t a paper packet, and nothing about your Sunshine contract carries into it.
There are two additional things worth knowing. First, AHCA has said Molina is prioritizing contracting inquiries that support continuity of care, which is a practical reason to get in the queue now rather than wait. Second, if you’re already in Molina’s network for another line of business, expect different instructions. Ask, don’t assume your path matches a first-time applicant’s.
Is there anything a clinic needs before it can even start?
Yes, you’ll need an active Florida Medicaid ID. Molina requires participating providers to be enrolled Florida Medicaid providers with a valid, active Medicaid ID issued by AHCA. If your enrollment has lapsed or is sitting mid-renewal, fix that first. It gates everything downstream, and in my experience it takes longer to sort out than the Molina paperwork itself.
Is there anything in the contract itself worth watching?
Yes, this applies to plan changeovers in general, not anything specific to Molina. When you re-credential, a new plan will sometimes propose different reimbursement. Say you were at 100 percent of the Medicaid rate, and the new contract offers 90 percent. Over the years, I’ve seen providers sign a 20 percent cut without realizing what changed.
Credentialing itself stays with the clinic, but we tell every client the same thing. Before you agree to anything from a Medicaid managed care plan, send us the fee schedule. We’ll compare it against what you’re actually being paid today. It takes very little time, and it’s hard to unwind later.
What’s the one thing you’d put in front of every clinic owner before October 1?
Get your credentialing done. After that, be patient, but be vocal. Know who your Molina provider representative is, and escalate when something isn’t working, including to the state. Clinics that outsource billing often go hands-off, and I understand why, but the plan tends to respond to the clinic in ways it doesn’t to the billing company. As a clinic owner, your voice carries weight. If a problem persists after you’ve raised it with the plan, AHCA’s Medicaid complaint process is a legitimate next step. Contact details are in the resources below.
Before October 1
- Start Molina contracting and credentialing now because your Sunshine contract doesn’t roll over.
- Compare the proposed fee schedule against current payment before you sign.
- Ask what payment setup your credentialing packet actually covered rather than assuming it’s handled.
- Identify your Molina provider representative and keep the contact somewhere your front office can find it.
Where EEP fits
EEP focuses on speech therapy, physical therapy, occupational therapy, and ABA therapy. Credentialing stays on the clinic’s side. What EEP brings is everything around it. We read proposed fee schedules against the rates a practice is paid today, keep payer setup current as plans change, and carry the claims, denials, and follow-ups that come after the contract is signed. If you’d like to speak with someone at EEP about outsourcing your billing, you can reach us here.
Continue the guide
The CMS Plan moves to Molina: what changes and how much volume is exposed.
What changes inside the claim: payer routing, remittances, and plan updates.
Denials and cash flow: lessons from the last transition.
Resources
Molina CMS Plan network inquiries: CMSplan@molinahealthcare.com / Provider Services (855) 322-4076
AHCA Medicaid complaints: 1-877-254-1055
General information reflecting EEP’s experience as of August 2026. This is not legal, coding, or reimbursement advice. Transition details are still developing and vary by plan. Verify current requirements with Molina and AHCA before you act.
