Search About ODM Our Services Resources News & Events Wednesday 05/25/2022 5:30:48 AM Skip to Providers Subsystem Menu Home Consumers Search Provider Directory Providers Enrollment Enrollment Tracking Search Long-Term Care Account Setup Trading Partners Public Information Fee Schedules Search Provider Directory Publications Publication Search Download Plug-ins Enrollment Enrollment Tracking Search Long-Term Care Account Setup Ohio Department of Medicaid » Instructions    Welcome to the online Provider Enrollment/Revalidation process. I need to enroll as a provider to bill Ohio Medicaid I need to revalidate my current Medicaid provider number I need to enroll for the sole purpose of Ordering, Referring, or Prescribing (ORP Provider) I need to enroll as a Comprehensive Primary Care (CPC) Provider Please complete each of the steps in the enrollment process. When you have completed all the steps, please click on the "submit" button to submit the application for processing. Please click the Checklist link prior to starting the enrollment application in order to select the checklist for your provider type. For instructions on completing the enrollment application please click on the question mark (?) in the title bar. Please click the "new application" button to start a new Provider Enrollment application or click the "continue application" button to continue with an existing application. If you are a provider currently rendering Medicaid services to consumers and wish to make changes to your name, address, email, etc., please login to the secured portal and select the Demographic Maintenance Tab. Please click the Forms Central link to access a comprehensive listing of forms and publications. To view documents regarding the administration and compliance of programs and services, please click the eManuals link. Your application will be saved until 12:00 EST Midnight in 3 days. At 12:00 EST Midnight in 3 days, your application will be deleted from the system if your application has not been submitted. FAQ for Provider Enrollment IMPORTANT - An Application Tracking Number (ATN) will be assigned to you. This number is necessary for accessing the status of submitted applications and for continuing an application that was not finished. Please write the number down and keep it for your records PRIOR TO EXITING. Please complete each of the steps in the revalidation process. When you have completed all the steps, please click on the "submit" button to submit the application for processing. For instructions on completing the revalidation application please click on the question mark (?) in the title bar. Please click the "revalidate application" button to start your Revalidation application or click the "continue application" button to continue with an existing Revalidation application. Please click the Forms Central link to access a comprehensive listing of forms and publications. To view documents regarding the administration and compliance of programs and services, please click the eManuals link. FAQ for Provider Revalidation IMPORTANT - An Application Tracking Number (ATN) will be assigned to you. This number is necessary for accessing the status of submitted applications and for continuing an application that was not finished. Please write the number down and keep it for your records PRIOR TO EXITING. You are about to begin an application to enroll with the Ohio Department of Medicaid for the sole purpose of ordering, prescribing or referring (ORP Provider). Please Note: You will NOT receive any Medicaid reimbursement as an ORP provider. If you are already an Ohio Medicaid provider, you DO NOT need to enroll as an ORP provider. See FAQ for ORP Providers for information about who can enroll and other important information. Your participation as an ORP Provider will allow billing Medicaid providers to receive reimbursement for covered services and supplies that you order, prescribe or refer for your patients. If you want to be reimbursed for providing Medicaid services, please change your selection at the top to "I need to enroll as a provider to bill Ohio Medicaid." If you have made the correct selection, please complete each of the steps in the enrollment process. Please click the "new application" button to start a new Provider Enrollment application or click the "continue application" button to continue with an existing application. When you have completed all the steps, please click on the "submit" button to submit the application for processing. For instructions on completing the enrollment application please click on the question mark (?) in the title bar. If you are currently an ORP provider and wish to make a change to your address, please login to the secured portal and select the Demographic Maintenance Tab. Your application will be saved for three days. At Midnight on the third day, applications that have not been submitted will be deleted from the system. IMPORTANT - An Application Tracking Number (ATN) will be assigned to you. This number is necessary for accessing the status of submitted applications and for continuing an application that was not finished. Please write the number down and keep it for your records PRIOR TO EXITING. You are about to begin an application to enroll with the Ohio Department of Medicaid as an Ohio Comprehensive Primary Care (CPC) Program provider. Ohio CPC is an investment in primary care, intended to support improved population health outcomes. Ohio CPC is a patient-centered medical home program, which is a team-based care delivery model lead by a primary care practice that comprehensively manages a patient's health needs. The goal is to empower practices to deliver the best care possible to their patients, both improving quality of care and lowering costs. Most medical costs occur outside of a primary care practice, but primary care practitioners can guide many decisions that impact those broader costs, improving cost efficiency and care quality. General eligibility requirements The following entities may participate through their contracts with MCPs or provider agreements for participation in Medicaid fee for service: Individual physicians and practices; Professional medical groups; Rural health clinics; Federally qualified health centers; Primary care or public health clinics; or Professional medical groups billing under hospital provider types. The following Medicaid providers are eligible to participate in the delivery of primary care activities or services in the Ohio CPC program: Medical doctor (MD) or doctor of osteopathy (DO) with any of the following specialties or sub-specialties: Family practice; General practice; General preventive medicine; Internal medicine; Pediatric; Public health; or Geriatric. Clinical nurse specialist or certified nurse practitioner who has met the requirements of section 4723.41 of the Ohio Revised Code and has any of the following specialties: Pediatric; Adult health; Geriatric; or Family practice Physician assistant who has met the requirements of section 4730.11 of the Ohio Revised Code Participating practices must have at least 500 attributed (claims-based) Medicaid individuals, attest that they will participate in learning activities as determined by ODM or its designee, and share data with ODM and contracted managed care plans (MCPs). Practice Partnerships Practices that meet the eligibility requirements of at least 150 claims-based attributed Medicaid members may participate in the model, but only as a practice partnership. The practice partnership as a whole should have equal to or greater than 500 claims-based attributed Medicaid members. Practices with at least 500 or more claims-based attributed Medicaid members may participate in Ohio CPC independently or as part of a practice partnership. Any eligible practice may participate in Ohio CPC and recieve PMPM payments, however only participants with at least 5,000 Medicaid members (either independently or through formation of a practice partnership) are eligible for total cost of care shared savings payments. Practices may choose to participate in a practice partnership to access eligibility for shared savings payments. Practice partnerships are led by a "convener" which must be a practice that has previously participated in Ohio CPC. All practices in the practice partnership must be individually eligible for the Ohio CPC program as outlined above. If you are convening a practice partnership, you should select provider specialty "991-CPC Practice Partnership" when completing the provider specialty panel. See Comprehensive Primary Care (CPC) Program for additional information. http://medicaid.ohio.gov/Provider/PaymentInnovation/CPC CPC for Kids Practices and practice partnerships that meet the eligibility requirement of at least 150 claims-based attributed Medicaid members under age 21 (either as an individual practice or across an entire partnership) may participate in CPC for Kids in addition to their CPC participation. Participation in CPC for Kids will allow practices to receive an additional PMPM payment for attributed Medicaid members under age 21. CPC for Kids participating practices and practice partnerships will also be eligible to receive bonus payments for high performance specific to their CPC for Kids attributed members. If you are interested in participating as a CPC for Kids practice in 2020, please select the secondary specialty 997-CPC Pediatrics on the Identifying Information panel to indicate your interest in enrolling in CPC for Kids. If you have made the correct selection, please complete each of the steps in the enrollment process. Please click the "new application" button to start a new Provider Enrollment application or click the "continue application" button to continue with an existing application. When you have completed all the steps, please click on the "submit" button to submit the application for processing. If you are a current Ohio CPC practice and wish to make a change to your address, please login to the secured portal and select the Demographic Maintenance Tab. Your application will be saved for three days. At midnight on the third day, applications that have not been submitted will be deleted from the system. IMPORTANT - An Application Tracking Number (ATN) will be assigned to you. This number is necessary for accessing the status of submitted applications and for continuing an application that was not finished. Please write the number down and keep it for your records PRIOR TO EXITING.    new application continue application revalidate application    Home | Privacy Statement | Contact Us AMA & ADA Copyright © DXC Technology. All rights reserved.