Ohio Medicaid’s annual open enrollment is underway. We know that members needs are everchanging, that’s why we encourage members to review the managed care plans available and select the one that best fits their healthcare needs. If a member has not selected a plan, they still have time! Members can make their plan selection through November 30. They do not have to do anything if they want to keep their current managed care plan. A member’s plan is effective the first day of the month following the selection.
Taking part in annual open enrollment allows members to focus on their family’s well-being. While reviewing plans, encourage members to keep the following in mind:
- Which plan communicates the way that is best for them and their family?
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What plan makes it easy for them and their family to make and keep appointments?
- Which plan supports them and their family’s health conditions or health goals?
To help members select a plan, there are several resources available. Share these resources freely and use them when assisting members during open enrollment.
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The find a provider search tool can help members identify which managed care plans their trusted providers are contracted or "in network" with. |
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The What is open enrollment? micro video provides an overview of what annual open enrollment is and the resources available to members. |
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Each managed care plan has a member website that members can visit to learn more about their approach to serving Ohio Medicaid managed care members:
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Members can explore the managed care plans available and enroll by visiting www.ohiomh.com or by contacting the Ohio Medicaid Consumer Hotline at (800) 324-8680. Representatives are available 7 a.m. to 8 p.m. Eastern time (ET) Monday through Friday and 8 a.m. to 5 p.m. ET Saturday. They can provide interpreters and answer member questions about open enrollment.
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Ohio Department of Medicaid (ODM) resumed provider revalidation notices in June 2023 as part of the federally required unwinding process from the COVID public health emergency. ODM issues a series of notices with the first one delivered 120 days before your Medicaid agreement end date. Subsequent reminders are issued at 90 days, 60 days, and a final notice at 30 days. If you receive a revalidation notice, it is important that you take action to complete your revalidation on time. All providers are subject to either 5-year or 3-year time-limited provider agreements.
How do you know if you are due for revalidation?
1. Check your mail and email.
Revalidation reminder notices are mailed and emailed to providers who are due for revalidation before the end of their Medicaid agreement. The email will be sent from OHPNM@maximus.com and will advise that there is a revalidation correspondence in the Correspondence folder in Provider Network Management (PNM) module. Please check your spam folder for this email.
2. View the Correspondence folder in the PNM module.
Revalidation notices are posted in the PNM module and can be accessed in the Correspondence folder. Please be sure to select the type of correspondence from the drop down (in this case <Enrollment Notices>), and search for the “Revalidation Notices.” Review the Accessing Communications within PNM Quick Reference Guide for step-by-step instructions.
NOTE: If you think you are due for revalidation but have not received notices, please login to the PNM module and verify that the primary contact information is accurate in accordance with your Ohio Medicaid Provider Agreement. All mailers and email notices are directed to the primary contact individual or address identified in the system.
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If I am due for revalidation, what action do I need to take?
A “Begin Revalidation” option appears in the PNM Enrollment Action Selections 120 days before the Medicaid Agreement end date. This can be found under the “Manage Application,” “Enrollment Actions” option within the provider file. Review the Revalidation/Reenrollment Quick Reference Guide for step-by-step instructions.
Credentialed providers whose revalidation date has passed will not see the “Begin Revalidation” option. ODM expects to provide the “Begin Revalidation” option for these credentialed providers through the PNM module starting October 26.
If you are currently in a PNM revalidation cycle, it is important that you take immediate action to complete and submit your revalidation to renew your Ohio Medicaid Provider Agreement. However, ODM is NOT currently terminating providers that fail to revalidate. As a reminder, revalidations resumed following the end of the public health emergency for providers due October 1 and after.
For more information
For technical support or assistance, 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.
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Ohio Department of Medicaid, in partnership with Maximus, the Provider Network Management (PNM) module vendor, is excited to share that we are continuing our provider awareness and training efforts. Registration for the November 6-16 PNM module refresher training is now open. The training schedule is available on the PNM and Centralized Credentialing page. Below you will find how to register and a list of training topics.
Learning management system training registration steps
Access the Absorb learning management system job aid and follow the steps to create your account and register for training. Absorb is where you can access virtual and self-paced training sessions. If you do not have an Absorb account, you must create one to access all training sessions, answer forms, and view a variety of PNM module resources.
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Provider Administrator User.
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Provider Agent User.
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Updating: Affiliations.
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Updating: Individual Practitioner Records.
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Updating: Group/Organization Records.
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Maintaining Behavioral Health Provider Records.
Note: additional details are available within the Absorb course listing.
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