Providers that are subject to credentialing must meet the conditions outlined in the Credentialing Guide and Requirements, including the requirement to purchase malpractice insurance. In reviewing uploads to the Council for Affordable Quality Healthcare (CAQH) portal, ODM noted missing malpractice insurance verifications among credentialed providers, especially school-based providers for enrollment or revalidation applications. School-based providers are employed by a school district or other school-based setting. These providers include, but are not limited to, speech language pathologists, occupational therapists, and psychologists. 

ODM can only complete credentialing for providers who submit sufficient malpractice insurance verification and must deny applications for providers who do not meet credentialing requirements. This includes terminating active providers without sufficient verifications at revalidation. It is important to submit and complete all credentialing requirements to avoid denials or terminations.

Employer malpractice insurance for credentialed providers 

Many credentialed providers are covered under the employer’s malpractice insurance policy and may not be required to obtain separate malpractice insurance. If you are a credentialed provider covered by your employer’s malpractice insurance policy, you must upload the following to the CAQH provider data portal:

1. Verification of the employer’s policy showing you are covered under the policy.
2. The effective dates of the policy. 
3. The coverage amounts of the policy. 

For more information  

For questions regarding this notice, contact Ohio Medicaid’s Integrated Helpdesk (IHD) at 800-686-1516 and follow the prompts for Provider Enrollment (option 2, option 2) or email IHD@medicaid.ohio.gov. Representatives are available Monday-Friday, 8 a.m.-4:30 p.m. Eastern time.

To learn more about the PNM module and Centralized Credentialing, visit the PNM and Centralized Credentialing page on the Next Generation website.