Skip to main content
Diagnostic Imaging Denial

Molina Healthcare Denied Your MRI Scan?

According to federal data, Molina Healthcare Inc. denies approximately 21% of claims. When patients appeal, about 42% are overturned. Your mri scan denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.

21%
Denial Rate
42%
Appeal Success
30-45 days
Typical Timeline
$1,200–$5,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why Molina Healthcare Denies MRI Scan

Prior authorization required but not obtained

Deemed not medically necessary at this stage

Lower-cost imaging (X-ray, CT) not tried first

Molina Healthcare's Common Denial Tactics

Denying specialist referrals as not medically necessary

Applying Medicaid criteria to marketplace plans

Delays in prior authorization processing

How to Win Your MRI Scan Appeal

Clinical notes explaining why MRI is specifically needed over other imaging

Documentation of symptoms warranting urgent imaging

Peer-to-peer review between ordering physician and insurer medical director

Laws That Protect You

ACA §2719 — Right to appeal imaging denials

No Surprises Act — Protection against balance billing

State laws requiring timely authorization decisions

Tips for Appealing to Molina Healthcare

Molina serves many Medicaid/marketplace enrollees — cite state Medicaid rules if applicable

File a complaint with your state Medicaid agency for Medicaid-managed care plans

Request expedited review if treatment is urgent

Ready to Review Your MRI Scan Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in Molina Healthcare's reasoning and outline your appeal options.

Analyze My Denial Free

Analysis is always free. No credit card required.

This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.

Molina Healthcare Denied Your MRI Scan? Here's How to Appeal | Lysco