News for Ohio Medicaid Providers

Focus on the Individual rather than the business of managed care

Ohio Department of Medicaid

ODM Press

December 8, 2023

The ODM Press is a periodic email update on the progress of the ODM strategic initiatives for providers, associations, and advocacy organizations.

In This Issue:

IMPORTANT UPDATE: Terminations to resume effective January 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management module

If you are currently due for a revalidation in the Provider Network Management (PNM) module, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. Ohio Department of Medicaid (ODM) will begin terminating providers who fail to complete their revalidation prior to their specified deadline, starting January 23, 2024.

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 prior to 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 imperative that you take action to complete your revalidation on time. All providers are subject to either three- or five-year time-limited provider agreements.

Claim Icon

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 prior to the end of their Medicaid agreement. The email will be sent from to advise you of a revalidation notice in the PNM Correspondence folder. 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.

Question Mark

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 prior to 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.

Info Icon

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 two, option two) or email Representatives are available Monday-Friday, 8:00 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.

Return to Top

New remittance advice report now available in the Provider Network Management module

New Resource

Ohio Department of Medicaid created a new provider report that explains non-claim, lump sum payments for programs such as the Hospital Care Assurance Program, Comprehensive Primary Care Program, Episodes of Care Program, etc. These payments are separate from regular weekly payments.

As of December 5, reports detailing lump-sum payments are available within the Provider Network Management module for all payments dating back to February 1. The reports are found in the same self-service location where all other PDF remittance advices are posted in the Provider Network Management module. We will continue to generate these reports for all future non-claim, lump sum payments paid through a special financial cycle.

The naming convention for these new reports is consistent with all PDF remittance advices, CCYYMMDD0000000000.pdf. The digits represent the payment date, followed by the provider's 10-digit National Provider Identifier (e.g., 202311090123456789).

Additional information on the adjudication process is available at Claims and Prior Authorization Submission Frequently Asked Questions on the Next Generation website. Providers can also contact the Ohio Department of Medicaid Integrated Helpdesk at 800-686-1516 or Representatives are available 8 a.m.-4:30 p.m. Eastern time, Monday - Friday.

Return to Top

Feel free to distribute the information contained within this update to your
colleagues, organization's members, or with anyone who you think might find it
useful. We want all Ohioans to know what is going on with ODM's strategic initiatives.

Please also encourage anyone who you think might be interested in receiving similar
updates to subscribe to the ODM Press.

Connect With Us


Our email address will remain active through transition to and implementation of Ohio
Medicaid's Next Generation program! We are always open to your ideas and feedback.
To view our past newsletters, please visit our website here.