The Ohio Department of Medicaid (ODM) successfully launched the Provider Network Management (PNM) Pre-Registration tool on August 15. To date, we have had several thousand providers successfully register their PNM accounts with OH|ID, and we look forward to onboarding more in the coming weeks. If you have not yet pre-registered, please be sure to do so by September 23! The pre-registration period allows providers to register for the PNM module and OH|ID ahead of time to prevent disruptions when PNM goes live on October 1. You can also take a moment to review a few facts and questions that we have gathered after week one below.
|
|
 |
#1 Who should identify themselves as a provider administrator or a provider agent?
A Provider Administrator manages and oversees one or more Medicaid IDs and is responsible for all aspects of provider registration. A Provider Agent can perform specific tasks based on roles granted by the Provider Administrator. Please confirm your role with your respective office or medical group before accessing the pre-registration tool, as only one Administrator is allowed per provider.
#2 How many Administrators can a provider have?
There can only be one Administrator per provider.
#3 If I already have an OH|ID do I need to pre-register?
Providers with an existing Medicaid number and OH|ID will not need to pre-register [i.e., Department of Developmental Disabilities (DODD) and Ohio Department of Aging (ODA) providers]. All others should take advantage of the pre-registration period in order to associate their accounts with their OH|ID and setup PNM dashboards in advance. When entering the tool, you will select “Yes” when asked if you already have an OH|ID and continue the process without having to create a new OH|ID.
#4 Will I be locked out of my account if I input the wrong information?
After three attempts of entering incorrect information on the provider verification page, you will be locked out of the system for one hour.
#5 Who do I contact if I need technical assistance while pre-registering?
If you need technical assistance or encounter an error while pre-registering, please contact the ODM Integrated Help Desk Command Center. They can be reached at 1-800-686-1516, option #8.
#6 Where do I find more information about pre-registration or the PNM module?
For more information on PNM pre-registration or the PNM module, please visit the PNM & Centralized Credentialing page on the ODM Managed Care site.
Return to Top
On July 1, Governor Mike DeWine announced the Ohio Department of Medicaid’s (ODM) launch of OhioRISE (Resilience through Integrated Systems and Excellence), Ohio’s first-ever highly specialized behavioral health program for children and youth with the most complex behavioral health needs who are served by Medicaid. Since then, OhioRISE has enrolled over 8,200 children and youth into the program!
OhioRISE was created with the goal of developing a child- and family-centric system of care that works to increase accessibility to in-home and community-based services to keep families together. In collaboration with child-serving state agencies, stakeholders, local community partners, care providers, and the Child and Adolescent Behavioral Health Center of Excellence, ODM developed the program’s key components and new and improved services. These services include Intensive and Moderate Care Coordination, Intensive Home-Based Treatment (IHBT), Behavioral Health Respite, Primary Flex Funds, and Mobile Response and Stabilization Services (MRSS). In 2023, ODM will incorporate Psychiatric Residential Treatment Facilities (PRTF), which is presently a service only provided outside of Ohio, into OhioRISE.
Did you know that ODM distributes a weekly OhioRISE Launch Report?
The OhioRISE Launch Report provides updates and highlights on the accomplishments, success stories, and impact of the OhioRISE program that week. Below are some of the highlights we have shared in the OhioRISE Launch Reports available on the OhioRISE Launch Information page of the OhioRISE webpage:
-
Aetna Better Health of Ohio (the OhioRISE plan) sent over 5,400 member packets to children/youth and caregivers before July 1.
-
The OhioRISE care management entities (CME) stuffed 2,500 backpacks with back-to-school supplies at the OhioRISE CME launch party and are distributing them to children and youth within their catchment areas at community events.
-
The director of a Children Services agency voiced appreciation for prompt OhioRISE services for a youth in their custody with multisystem needs who was enrolled in OhioRISE on July 1.
-
ODM hosted the OhioRISE booth at the Ohio State Fair and learned from families about how the OhioRISE program is positively impacting their communities.
|
 |
|
If you have any questions about the OhioRISE launch and implementation, please attend OhioRISE implementation open office hours, available every Tuesday from 2-3 p.m. until August 30. Click here to join the office hours meeting each week. Click here for an overview of the OhioRISE launch announcement and read the OhioRISE launch announcement press release. Additional information about the OhioRISE program can be found on the OhioRISE webpage. |
Return to Top
A state-level provider directory is one of the exciting features of the new Provider Network Management (PNM) module, which will go live October 1. This comprehensive provider network directory will also display managed care organization (MCO) affiliation and provider affiliations by service location.
To support our members and ensure a complete directory at launch, providers must update all addresses in MITS, add all alternate service locations, and check group and group member affiliations are up to date. After August 30, the next opportunity to update your information will be October 1, when PNM goes live.
For more information about other changes happening with PNM, please visit: www.managedcare.medicaid.ohio.gov/managed-care/centralized-credentialing
Return to Top
As a part of the OhioRISE program, ODM utilizes waivers that provide ODM with more flexibility when implementing Medicaid programs. OhioRISE utilizes the Home- and Community-Based Services 1915(c) waiver to help youth who need services and support to stay in their home and communities, rather than in institutions.
In addition to standard OhioRISE or general behavioral health services, children and youth who meet OhioRISE 1915(c) eligibility requirements will have access to three additional services: out-of-home respite, transitional services and supports (TSS), and secondary flex funds. The services provided by the OhioRISE 1915(c) waiver will help children and families to function to the highest degree possible and will support children in having a safe, healthy, and educational childhood and a chance at a bright future.
Find out more about the 1915(c) waiver, including services and eligibility requirements, by watching the new micro-video below. We also encourage providers to view the OhioRISE 1915(c) training to learn more about topics like waiver slots, billing, coding, reimbursement, and more. Click here to view the training presentation materials and click here to view the training recording.
Return to Top
You spoke, and we listened! Based on feedback received in recent webinars and training sessions, we are excited to announce the addition of a new “Enrollment Agent” role within the Provider Network Management (PNM) module. This new role will be able to update provider information and submit revalidations on behalf of a provider. Like the Agent role, the Enrollment Agent will be assigned by the Provider Administrator.
Return to Top
Important changes that may impact you as an Ohio Medicaid (ODM), Department of Developmental Disabilities (DODD), or Ohio Department of Aging (ODA) provider are coming, and we want to make sure you’re aware of them.
On August 1, the Ohio Department of Medicaid (ODM) temporarily stopped accepting provider enrollment applications as we transition to the new Provider Network Management (PNM) module. New provider enrollment applications are on hold until October 1. ODM can backdate enrollment after verifying the provider meets all eligibility criteria for the time period.
Beginning August 31, all provider demographic and agent maintenance update functionality will be closed for conversion of data in MITS. Enrolled providers should update their demographic information in MITS by August 30 or plan to hold updates until October 1. Please visit the following link to the MITS Secure Portal Login:
www.ohmits.com/prosecure/authtam/login
Please make sure to add or update all practice locations and provider affiliations in advance of data conversion.
For more information visit:
Send questions to:
For providers certified by DODD, please click here to learn more and view important cut-off dates. For more information visit: www.DODD.Ohio.Gov
Send questions regarding provider certification to:
For providers certified by ODA, please click here to learn more. For more information visit: www.Aging.Ohio.Gov/certification-changes
Send ODA provider certification questions to:
Return to Top
As you are likely aware, Ohio Medicaid is in the process of implementing our Next Generation program to focus on the individual rather than the business of managed care so that we can do better for the people we serve. One way we hope to achieve this vision is through the implementation of the Provider Network Management (PNM) module to reduce the administrative burden on providers.
Training and Learning Management System
In preparation for Stage 2 go-live (October 1, 2022), we are offering a variety of training options including self-paced, virtual, and in-person training options. Absorb, the Learning Management System (LMS), is where you will access the self-paced training and sign up for the virtual and/or in-person sessions.
LMS Registration
It is important that you create an account in the LMS to ensure you have access to all training sessions, answer forms, and PNM resources in advance. Click on the appropriate link below, based on your provider type, to access the LMS and follow the steps to create your account and register for training:
Questions
Please email OhioTrainingTeam@maximus.com with any questions regarding training sessions or additional information.
About the PNM and Centralized Credentialing
The PNM module and Centralized Credentialing program are part of the “Big 5” strategic initiatives being implemented within the Next Generation of Ohio Medicaid’s managed care program.
The PNM will replace the current Medicaid Information Technology System (MITS) provider enrollment subsystem provider portal. This module will be implemented along with Centralized Credentialing, which is a state-level single centralized provider credentialing process. These initiatives will modernize the system by streamlining processes and reducing administrative burdens for providers. For more information about PNM and Centralized Credentialing, visit the Managed Care website.
Thank you in advance for your consideration and for your support of ODM’s Next Generation vision.
Return to Top
|
