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Molina Healthcare of New York, Inc. fax number

(844) 879-4471

Member Appeals

Used for: Submitting a Member Appeal Request Form (e.g., for services being reduced, suspended, or stopped) to Molina Healthcare of New York, Inc.

Fax destination details

Department
Member Appeals
Purpose
Submitting a Member Appeal Request Form (e.g., for services being reduced, suspended, or stopped) to Molina Healthcare of New York, Inc.
Form
Member Appeal Request Form — Member Appeal Request Form
Address
2900 Exterior Street, Suite 202, Bronx, NY 10463
Voice phone
(800) 223-7242

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Submit the Member Appeal Request Form via fax to 1-844-879-4471; include member information and reason for the appeal; follow Molina NY guidelines for appeals.

Official form instructions are published as a downloadable file on the organization's website.

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