Only two weeks are remaining of the Provider Network Management (PNM) pre-registration period. Providers have until Friday, September 23, to pre-register for the PNM module ahead of the PNM launch on October 1. As a reminder, an OH|ID is required to access the PNM module. Access to key administrative functions could be delayed for providers who do not pre-register. If you cannot take advantage of pre-registration, you will still be able to access the PNM and set up your account at go-live October 1.
Return to Top
The Gainwell Ohio SPBM training staff would like to remind prescribers, prescriber support staff, pharmacists, and pharmacy support staff that it is not too late to register for SPBM Web Portal training!
Please join us to learn the difference between the public and the secure portals, including how to register for the latter. The public facing SPBM Web Portal provides instant access to reference material such as the Unified Preferred Drug list (UPDL) and criteria, the Preferred Diabetic Supply list, the Specialty Drug list, and Quantity Limits list to assist with prescribing medications to Ohio Medicaid Managed Care members.
The secure SPBM Web Portal requires credentials which provides a way for users to check eligibility of Ohio Medicaid managed care members, the ability for prescribers and designated support staff to submit prior authorizations, the ability for pharmacies to submit claims, users to view claim and prior authorization history, and a secure web chat to quickly speak with the SPBM help desk.
Registration instructions can be found by navigating to https://spbm.medicaid.ohio.gov and selecting the provider tab. Under the provider tab, you will find the associated menu for “SPBM Web Portal Training.” The provider trainings dates are as follows:
-
Prescriber and prescriber support staff: Training began September 6 and will remain open until our last class on September 15.
-
Pharmacy and pharmacy support staff: Training begins September 19.
If you are unable to attend one of the live instructor-led webinars, it is still important to register for the Gainwell Ohio Learning Management System (LMS) so that you will have access to the recorded training. Once the recorded training is available on the Gainwell Ohio LMS, an announcement will be placed in the “Announcement” area of the SPBM web portal’s home page.
If you have any questions regarding SPBM web portal training, please email OH_MCD_PBM@gainwelltechnologies.com.
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
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.
The Ohio Department of Medicaid (ODM) has temporarily paused all provider enrollment and maintenance activities during this transition. On October 1, provider enrollment and maintenance-related activities will resume and be submitted using PNM. Organizational or individual practitioners who will provide services covered by the OhioRISE program and behavioral health community providers may enroll with Medicaid and add OhioRISE provider specialties between August 1 and September 30 to begin providing and billing for services. The guidance was updated on August 31, please view the Updated Community BH and OhioRISE Provider Enrollment During System Transition for direction on this process.
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
|
