Managedcare.medicaid.ohio.gov

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PNM & Centralized Credentialing

WEBOhio Department of Medicaid (ODM) is excited to announce that the Provider Network Management (PNM) module went live on October 1, 2022! The PNM …

Actived: 6 days ago

URL: https://managedcare.medicaid.ohio.gov/wps/portal/gov/manc/managed-care/centralized-credentialing

Ohio Department of Medicaid Announces Six Partners to Further …

WEBOhio Department of Medicaid Director Maureen Corcoran today announced the selection of six health care organizations to lead the department’s evolution of …

Category:  Health Go Health

OhioRISE care coordination overview

WEBLast updated: January 23, 2023 1 . OhioRISE care coordination overview . What is OhioRISE? OhioRISE (Resilience through Integrated Systems and Excellence)is a …

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OhioRISE (Resilience through Integrated Systems and Excellence)

WEBAs a part of Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM has launched OhioRISE (Resilience through Integrated Systems and Excellence), …

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Next Generation Managed Care Benefits

WEBCommunity investment: Together, with the Next Generation managed care plans, Ohio Medicaid is investing in the local communities where members live by working with …

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About OhioRISE Ohio Medicaid Managed Care

WEBAbout OhioRISE. OhioRISE aims to shift the system of care and keep more kids and families together by creating new access to in-home and community-based services for …

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Last updated: June 28, 2023 Ohio Medicaid Managed Care …

WEBhave a question about Medicaid managed care eligibility, coverage, benefits, managed care plan selection, or something else Call the Ohio Medicaid …

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Provider Contracting Information

WEBAll pharmacies will have to contract with Gainwell to provide pharmacy services for Medicaid managed care members. For pharmacy contracting questions, Gainwell may …

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Submitting Claims and Prior Authorizations

WEBAs of October 1, 2022, the Single Pharmacy Benefit Manager (SPBM) is the entry for pharmacy claims and prior authorizations for managed care members. This does not …

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OhioRISE Frequently Asked Questions

WEBUpdated June 30, 2022 *Additional information may be added, and all content is subject to change as OhioRISE is implemented. OhioRISE . Frequently Asked Questions

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OhioRISE Community and Provider Training

WEBTo request a reasonable accommodation due to a disability, please contact ODM’s ADA coordinator at 614-995-9981/TTY 711, fax 1-614-644-1434, or email …

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Provider Enrollment and Specialty Addition Guidance for …

WEB9/2/2022 1. Provider Enrollment and Specialty Addition Guidance for OhioRISE Behavioral Health Respite Services. Behavioral Health (BH) Respite provides a short-term …

Category:  Health Go Health

Next Generation Pharmacy Program: Pharmacy …

WEBRole of the Single PBM HB 166 of the 133rd Ohio General Assembly required Ohio Medicaid to select a single PBM to address: •Lack of transparency. …

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OhioRISE Provider Enrollment and illing Guidance

WEBv Legal Disclaimer: Ohio Department of Medicaid (ODM) strives to make the information in this guidance document as accurate, complete, reliable, and timely as …

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Governor DeWine Announces Launch of OhioRISE, First-Ever …

WEBOhio Governor Mike DeWine today announced the official launch of Ohio Resilience through Integrated Systems and Excellence (OhioRISE), a new Ohio …

Category:  Health Go Health

Centralized Credentialing FAQ

WEBDelegated credentialing is when a hospital system or other organization enters into a memorandum of understanding (e.g., delegated agreement) with ODM, allowing the …

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OhioRISE Frequently Asked Questions

WEBUpdated July 26, 2021 *This FAQ will continue to be revised as the services and components of the program are being developed and all responses are subject to change. .

Category:  Health Go Health

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