Welcome Providers

Ohio is home to more than 83,000 active Medicaid providers. The partnership between Ohio Medicaid and its provider network is critical in ensuring reliable and timely care for beneficiaries across the state. In the months ahead, this page will become a go-to resource for learning more about training, billing, rate-setting and additional areas interest concerning the provider community.

Provider News

NEW - State Fiscal Year-End Provider Payments
The Ohio Administrative Knowledge System (OAKS), that processes our Medicaid provider payments, will be experiencing a delay due to the fiscal year-end processing and the July 4th holiday. The last provider payments for SFY 2017 will be Thursday, June 22, 2017. Therefore, there will be 2 weeks of delayed provider payments (payment dates June 29th and July 6th) made no later than Monday, July 10, 2017.

Please listen carefully when calling the IVR as the options have changed as of 6/17/2016.

ICF-IID 9400 Provider Notice

Managed Long-Term Services and Supports Stakeholder Meeting

Managed Long-Term Services and Supports Stakeholder Meeting Invitation (3/31/2017)

Notice Regarding Pregnancy Risk Assessment and Notification System (4/14/2017)

Timely Filing Reminder for ICF-IID Providers (6/29/2016)

Independent Provider Overtime Rates - Effective January 1, 2016 (Rev. 4/1/16)

Post-Implementation ORP FAQs

Medicaid Requirements for Ordering, Referring, and Prescribing (ORP) - Effective January 12, 2015

Pay and Post Period for Ordering, Referring and Prescribing Provider Requirements

Provider Enrollment Application Fee

Behavioral Health Provider Integration Project

Nurse and Aide Service Rate Modernization

Primary Care Clinician Report Cards available on the MITS Provider Portal beginning June 27

The Primary Care Clinician Report Card Initiative was created in alignment with Office of Health Transformation's goals of transparency and improved performance by providing meaningful information to those who provide healthcare services. Through the primary Care Clinician Report Cards, clinicians will be able to compare their performance to the performance of other clinicians serving the Medicaid population in Ohio and take important steps to improve the quality of care delivered to and health outcomes of Medicaid patients.

Sample Report Card
User Guide
Frequently Asked Questions
Episode of Care Reports Available on the MITS Provider Portal

This is a reminder, Episodes of Care Performance Reports are posted on the MITS Portal under the Report tab for Hospitals, Physicians, Group Providers, Clinics and Federally Qualified Health Centers. These reports show your cost of care per Episode, how your costs compare to your peers and should be shared with your Organization’s Leadership including your Medical Director/Quality Management. Your Portal Administrator has the role to view these reports. If you have questions about these reports or how to access them, call ODM Provider Services at 1-800-686-1516. (NOTE: Your practice/facility may not have Episode Reports if you did not have enough qualifying Episodes.)

Mandatory Waiver Provider Training

This notice is to inform all providers of services to individuals on an Ohio Department of Medicaid (ODM) home and community-based services waiver of mandatory training on incident management. An “incident” is an alleged, suspected or actual event that is not consistent with the routine care of, and/or service delivery to, an individual enrolled on an ODM waiver.

The mandatory training can be viewed at http://ohiohcbs.pcgus.com/TrainingMaterials/ In addition, upon entering into a Medicaid provider agreement, and annually thereafter, all providers must acknowledge in writing they have reviewed Ohio Administrative Code Rule 5160-45-05 Ohio department of Medicaid (ODM)-administered waiver program: incident management system, which can be found at http://codes.ohio.gov/oac/5160-45-05

Questions may be directed to ODM’s contracted Provider Oversight Contractor, Public Consulting Group (PCG) at 1-877-908-1746.