Ohio Medicaid Next Generation February 1 Launch Resources
Over the past year, Ohio Department of Medicaid (ODM) has prepared for and successfully launched many components of the Next Generation Ohio Medicaid program. Our implementation has consistently followed two of our key Next Generation commitments – to focus on the individual and improve the provider experience. We will continue implementing new components and improvements as they are fully ready to support our mission. Next we are implementing the Next Generation managed care plans, new Electronic Data Interchange (EDI) module, and Fiscal Intermediary (FI) on February 1, 2023.
The Next Generation managed care plan changes and EDI trading partner transactions do not apply to MyCare Ohio plans, which will continue to provide benefits to Ohioans who receive both Medicaid and Medicare benefits, with enhanced coordination of medical, behavioral, and long-term care services.
What you need to know for the February 1 launch
We recognize that you, our partners, are often the first contact for member and provider questions – our goal is to provide you with materials to describe the changes they will experience, ways they can get support, and where you can go for answers to their questions. As always, we will continue to keep you all updated and share additional resources as they are available closer to February 1.
Attached to this email and linked below are a variety of resources you can use to spread the word and guide members and providers in understanding the February 1 launch:
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What’s changing February 1? Learn about the Next Generation program and the initiatives that have been and will be launched, by reviewing the Next Generation Ohio Medicaid Program Overview document.
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Where to get answers for common questions? The Ohio Medicaid Managed Care Member frequently asked question (FAQ) document and Ohio Medicaid Managed Care Plan Provider FAQ will answer questions related to the implementation of the Next Generation plans for both members and providers.
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Where to direct members with questions? Ohio Medicaid members can reach out to the help desks listed below or review the February 1 Ohio Medicaid Member Help Desk One-Pager.
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Questions related to Medicaid managed care eligibility, coverage, benefits, managed care plan selection, your Next Generation member ID card, or other Ohio Medicaid topics should be directed to the Ohio Medicaid Consumer Hotline at 800-324-8680 or by visiting https://ohiomh.com/.
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Questions related to value-added benefits provided, issues receiving services, assistance finding a provider, or non-emergency transportation should be directed to the member’s Next Generation managed care plan.
- Aetna Better Health of Ohio: 833-711-0773
- AmeriHealth Caritas Ohio, Inc.: 833-764-7700
- Anthem Blue Cross and Blue Shield: 844-912-0938
- Buckeye Health Plan: 866-246-4358
- CareSource: 800-488-0134
- Humana Healthy Horizons in Ohio: 877-856-5702
- Molina HealthCare of Ohio, Inc.: 800-642-4168
- UnitedHealthcare Community Plan: 800-895-2017
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Where to send providers for assistance? Ohio Medicaid providers can reach out to the help desk listed below or review the February 1 Ohio Medicaid Provider Help Desk One-Pager.
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Questions related to Ohio Medicaid Enterprise System (OMES) submitted claims or prior authorizations, or other administrative tasks, should be directed to the ODM Integrated Help Desk (IHD) at 800-686-1516 or IHD@medicaid.ohio.gov.
As we approach February 1, ODM is currently working on additional member and provider resources that will be available on the Next Generation website, ODM Press, or ODM Periodical.
We appreciate your willingness to support Ohio Medicaid, its members, and its providers as we take the next step in realizing the Next Generation program mission to focus on the individual rather than the business of managed care. As always, if you have any questions, please email the Next Generation mailbox.
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