Latest News

New ODM10304 form for PNM Admin transfers

Ohio Department of Medicaid (ODM) developed a new form, ODM10304, that must accompany specific requests to change Provider Network Management (PNM) Administrators across organizations. Please review the ODM Press article for further detail and exceptions.
PNM learning resources

Click the "Learning" tab in the top menu of the PNM application to access user guides and quick reference guides. Note: You do not need to be logged in to access this menu.

Disenrollment Quick Reference Guide is available

The Provider Network Management (PNM) Disenrollment Quick Reference Guide offers step-by-step instructions on disenrolling a provider from Ohio Medicaid within the PNM module. These steps should only be completed if you wish to request the withdrawal of a provider’s enrollment with Ohio Medicaid. Once completed, the Medicaid ID assigned to that provider will no longer be active.

Claims Submission Notice

Claims submitted after 12:00 p.m. on Friday, June 23, will be held for processing until the Ohio Administrative Knowledge System (OAKS), the state's accounting system, is up and running for state fiscal year (SFY) 2024 (beginning July 1). The Ohio Department of Medicaid anticipates issuing final provider payments for SFY 2023 on Wednesday, June 28, however, fiscal year-end processing may cause a delay in payment until OAKS is up and running for SFY 2024. The Ohio Department of Medicaid anticipates issuing the first payment of SFY 2024 to providers on July 7. Please note, as a result of fiscal year-end processing and the July 4 holiday, OAKS processing may experience a brief delay and payment may not be made until the week of July 10.

Reminder: Update addresses and affiliations in the Provider Network Management (PNM) module. It is imperative that providers update all address and affiliation information in the PNM so that claims payments, provider directories, and network adequacy measurements are not negatively impacted. Click on the following links for step-by-step instructions on how to complete these actions.

Fee Schedules

As part of our Next Generation program transition, Ohio Department of Medicaid (ODM) has transitioned our fee schedules from the Fiscal Intermediary (FI) to the Provider Network Management (PNM) portal. ODM is working to include corrections to the posted fee schedules. Please be advised that in the meantime, providers can access the correct fee schedule at: Schedules and Rates | Medicaid (ohio.gov)Note: Adjustments may be made for any incorrect payment rates.

Incomplete PNM affiliation steps may impact provider billing

Through a series of PNM queries, Ohio Department of Medicaid (ODM) has identified several affiliation issues that impact billing organizations claims. It is imperative that providers fully execute all steps when affiliating a rendering provider to their group/organization/hospital to avoid claims payment issues. An Affiliations Quick Reference Guide (QRG) has been created, showing step-by-step instructions and information related to entering an affiliation as a new individual practitioner; confirming, adding, and removing an individual practitioner’s affiliation as a group or organization.

Next Generation of Ohio Medicaid February 1 release

Visit the Ohio Medicaid Managed Care website to learn more about the February 1 release.

Integrated Helpdesk support hours

For technical support or assistance, contact the IHD at 800-686-1516 or IHD@medicaid.ohio.gov. Representatives are available 8 a.m.-4:30 p.m. (EST) Monday-Friday.

Additionally, the Interactive Voice Response System (IVR) provides 24/7 access to information regarding client eligibility, claim and payment status, and provider information.

Why use OH|ID?

When creating a new account, you will be required to create an OH|ID. OH|ID is a secure web portal designed for Ohioans to access information and conduct business with a variety of state agencies, including Medicaid, all in one place. Visit https://ohid.ohio.gov/wps/portal/gov/ohid/help-center to learn more about OH|ID and available support options.

ODM trading partners

Visit the trading partner webpage for Medicaid claims reimbursement information.