The process of reporting exemptions to copayment provisions within rule 5160-1-09 of the Ohio Administrative Code during claim submission has changed. Under the new process, exemptions to copay provisions will be identified automatically by the fiscal intermediary upon claim submission. 

Conversely, the provisions for collecting a copayment for non-emergency services provided in an emergency department are described in rule 5160-2-77 of the Ohio Administrative Code. The amount of the copayment collected should be reported on an institutional claim with value code D3. This updated process will be reflected in the Ohio Department of Medicaid’s 837I Companion Guide.

The Ohio Department of Medicaid (ODM), 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. Provider Refresher Training is scheduled for May 12 - 21.

Registration steps for enrolling through the learning management system

Access the Absorb learning management system to register for the training. If you do not have an Absorb account, you must create one to access all training sessions, answer forms, and view various PNM module resources. For help, please see our job aid and follow the steps to create your account and/or register for training.

Training topics

• Provider Administrator and Power Agent Role
• Provider Agent Role
• Updating/Changing Medicaid Enrollment Information
• Prior Authorizations
• Entering and Searching for Professional Claims

Note: Additional session details are available within the Absorb course listing.

For more information

If you are experiencing technical issues accessing the PNM module or have specific questions, please contact the ODM Integrated Helpdesk at 800-686-1516 from Monday through Friday 8 a.m. - 4:30 p.m. Eastern Time. You can also email your questions to IHD@medicaid.ohio.gov.

Sandata/HHAeXchange, the Ohio Department of Medicaid’s (ODM) Electronic Visit Verification (EVV) system partner, is making support and learning faster, better, and easier for providers. Three new portals are going live April 20. 


1. Sandata’s Customer Support Portal is getting a fresh new look! Improved functionality, easier navigation, and a modern design. Providers will be able to submit tickets quickly and follow a streamlined tracking process for faster resolutions from Sandata’s Technical Customer Care (TCC) team. See how it works.
   • Sandata’s TCC team can still be reached by using the phone numbers and emails providers know.
     • Sandata EVV providers can call 855-805-3505 or email ODMCustomerCareEmail@Sandata.com.
     • Sandata Alternative EVV providers can call 844-289-4246 or email OHAltEVV@Sandata.com.
2. Sandata Learn will be moving to HHAeXchange University. The upgraded version will feature a modern interface, enhanced functionality, and more intuitive navigation to make finding support videos and materials easier. The content providers rely on today will migrate to the new site. It will also house new resources as they become available. Take a look at what's in store.
3. Sandata on Demand is getting a new home and a new name. It will become Sandata Knowledge Base offering richer functionality, intuitive navigation, and Caree, a virtual assistant for instant answers and training resources. Learn more and take a look here!


ODM and Sandata/HHAeXchange are committed to making this a smooth transition. We’ll be sharing more information about these new upgrades in the days ahead, offering more insight on how to prepare for the transitions ahead.

The Ohio Department of Medicaid (ODM) is issuing a reminder to help make sure provider calls related to the Next Generation MyCare program are routed accurately and handled as efficiently as possible. Proper use of the phone menu options helps reduce call transfers and makes sure providers reach the appropriate Next Generation MyCare plans without delay.

Direct Next Generation MyCare Inquiries to the Correct Plans

Providers with questions regarding eligibility, claims, prior authorization, payments, replacement member ID cards, or any other Next Generation MyCare program matters should contact their plan directly.

When calling the Integrated Helpdesk (IHD) at 800-686-1516, providers should:

1. Select Option 9 for all Next Generation MyCare–related inquiries.
   • Option 1 should not be used, as it is designated solely for Fee‑for‑Service (FFS) inquiries.
2. After selecting Option 9, callers will be directed to the plan menu, where they may:
   • Select Option 1 for Provider
   • Select Option 2 for Next Generation MyCare Provider
   • Then choose the option for the appropriate Next Generation MyCare plan

Using the correct Interactive Voice Response (IVR) options ensures calls are routed accurately, reduces unnecessary transfers, and speeds up resolution of provider questions.

ODM appreciates the continued partnership and attention to this important reminder.

A message to our Ohio Medicaid Providers, Provider Administrators, Power Agents, or Agents

The Ohio Department of Medicaid (ODM) is committed to safeguarding provider data. To support that commitment, ODM has updated the Provider System Administrator Change Request process and introduced new requirements and recommended best practices to ensure strong data integrity and confidentiality.

Updated PNM Administrator Change Request Form

Effective January 1, ODM released an updated PNM System Administrator Change Request Form (ODM 10304). The revised form adds a new requirement and includes a full ODM review for administrator changes within facility, group, or organizational provider types. 

Option 1 – Organizational Administrator Change (Non–Self-Service)

Use Option 1 ONLY when the PNM self-service option is unavailable and the organization needs to change the PNM Administrator.

This option requires:

• A completed ODM 10304 form, and
• A letter on organizational letterhead, signed by an authorized senior leader, stating: “The PNM Administrator Change Request has been reviewed and approved by the appropriate staff within the organization.”

Submit both documents to the ODM Integrated Helpdesk (IHD) at IHD@medicaid.ohio.gov. Requests submitted under Option 1 require full ODM review and additional processing time. Providers are encouraged to use the PNM self-service option whenever possible for immediate updates.

Option 2 – Individual Providers

Option 2 applies to individual providers who need to assign someone else to serve as the PNM Administrator when the self-service function is not available. These requests are subject to standard reviews, and most are processed quickly.

Recommended Security and Compliance Practices

To support secure and consistent system administration, ODM recommends that providers:

• Establish clear governance structures defining roles, responsibilities, and decision-making authority.
• Maintain written policies and procedures for compliance and oversight.
• Document approval workflows to support accountability and transparency.
• Develop contingency plans to ensure continuity during administrative changes.

By adopting these practices, ODM aims to promote secure, consistent, and accountable management of PNM administrator roles.

Questions? Contact the ODM IHD at IHD@medicaid.ohio.gov.

Thank you for your continued partnership in supporting Ohio Medicaid.