Welcome Providers
Ohio is home to more than 165,000 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. Please use this page as a go-to resource for learning more about training, billing, rate-setting and additional areas of interest concerning the provider community.
Provider News
- UPDATED State Fiscal Year-End Provider Payments (5/13/21)
- New Utilization Review Vendor for Ohio Department of Medicaid (11/29/18)
- Waiver Provider Signature Requirement - Effective December 31, 2018
- Qualified Entity Technical Help Desk Changes
- Qualified Entity Policy Email Template
- Qualified Entity Technical Email Template
- Instructions for Ohio Benefits QE Incident Email Template and Submission
- Proton Pump Inhibitor (PPI) Coverage (6/8/18)
- State Fiscal Year-End Provider Payments and Payment Delay (5/25/18)
- Captcha Notes (3/29/2018)
- Change in Payment Cycle for Specific Fee for Service Providers (2/22/18)
- Electronic Visit Verification Changes for Professional Claims
- Additional Provider Information - Panel Instructions
- ICF-IID 9400 Provider Notice
- Managed Long-Term Services and Supports Stakeholder Meeting
- Online Pregnancy Risk Assessment and Notification System (PRAF 2.0)
- Timely Filing Reminder for ICF-IID Providers (6/29/2016)
- Independent Provider Overtime Rates - Effective January 1, 2016 (Rev. 4/1/16)
- Nurse and Aide Service Rate Modernization
Standard Authorization Form
Providers should be aware that a new form, Standard Authorization Form (Form Number: ODM 10221), is now available. The purpose of the form is to improve care coordination for a patient across multiple providers by making it easier to share protected health information in a secure manner. The form is applicable to all covered entities in Ohio. It is not required to be used, but a properly executed form must be accepted by the receiving entity. The requirement to accept a properly executed form is applicable within 30 days of January 3, 2019.
- Standard Authorization Form | Spanish
- Instructions for Completing Standard Authorization Form | Spanish
- Additional details about the Standard Authorization Form are available in the fact sheet
- Questions about the Standard Authorization Form may be directed to StandardAuthForm@medicaid.ohio.gov
- Introductory video on the Standard Authorization Form
- Instructional video on the Standard Authorization Form
- Ohio Hospital Association Standard Authorization Form Webinar
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 https://ohiohcbs.pcgus.com/TrainingMaterials/index.html 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.