The Ohio Department of Medicaid (ODM) requires entities to complete an online application (Medicaid Trading Partner Form) as well as a signed Trading Partner Agreement (TPA) to initiate the process of becoming an authorized trading partner.
It can take several weeks for the TPA to be routed for approval and signatures within ODM. Once complete, the EDI Support team will notify the contacts provided on the application of the next steps.
This form gives ODM general information about your company (i.e. tax id., contact information, and the transactions you wish to submit/receive).
Medicaid Trading Partner Form
Call EDI Support at (844) 324-7089 with any questions.
Providers and Trading Partners must fill out the ODM Designation of an 835 or 834-820 Trading Partner Form (Instructions) to receive the optional 835 remittance advice on behalf of their billing and/or pay-to providers. The preferred method is in an attachment to an email.
Trading Partners can fill out an Authorization to Post Trading Partner form if they wish to advertise their services to providers in need of a trading partner. This information is posted on the ODM Trading Partner website.
Medicaid tape billing instructions for National Standard Form (NSF) and Flat File Versions IV and VI: (Note: These are for Sister Agencies only).