Molina Healthcare Denied Your MRI Scan?
Published data shows denial and appeal outcomes vary by plan, product year, denial reason, and documentation. Use this page to spot the issues to request and the evidence to gather before you decide what to submit.Sources include KFF ACA Marketplace Transparency Data, HHS OIG reports, and state insurance department filings. Aggregate rates are context, not predictions for an individual case.
Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.
Why they said no
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 patterns
Molina Healthcare's Common Denial Patterns
Denying specialist referrals as not medically necessary
Applying Medicaid criteria to marketplace plans
Delays in prior authorization processing
What works
How to Strengthen 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
Your rights
Laws That Protect You
ACA §2719 — Right to appeal imaging denials
No Surprises Act — Protection against balance billing
State laws requiring timely authorization decisions
Playbook
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
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Related denial guides
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MRI Scan denials by other insurers
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.