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February 27, 2017

Vision Services

Vision services, and materials, requiring a prior authorization should be submitted by fax on the appropriate request form with previous and current prescription information. All orders for eyeglass lenses, frames, and contact lenses must be submitted to Classic Optical Laboratories, Inc.. Vision providers may submit requests, with supporting documentation, for medical conditions which do not meet criteria noted in the handbook. Special requests will undergo review by Medicaid’s Medical Director. For additional information about vision services you may also look at Administrative Rule, IDAPA

EPSDT reviews are done at the Medical Care Unit’s discretion. If the request does not meet state plan criteria it can be reviewed under EPSDT. Approval under EPSDT will be noted in the decision notes. Please, remember that billing must submit claim with the EP modifier.

The status of a prior authorization request may be checked online at the Molina Health PAS portal under “Authorization Status”, using your NPI, or by contacting Molina at (866) 686-4272. If you have questions on a Denial, click on the Notes, which will explain the reason for the Denial, or ask the Molina Customer Service Representative to read you the Notes in the Denial.



Vision Services

 Phone: 1 (208) 364-1833
Fax: 1 (877) 314-8779