06/24/2024

Next Generation of Ohio Medicaid June 30 Implementation Is Almost Here! Resources Available

Source: Ohio Department of Medicaid ODM Press

On June 30, the Ohio Department of Medicaid (ODM) will implement new features in the Ohio Medicaid Enterprise System (OMES). Providers will see and utilize these new features in the Provider Network Management (PNM) module. The new OMES features in the PNM module will increase visibility for providers of claims submitted by trading partners, streamline fee-for-service (FFS) claims and prior authorizations submission, and improve self-service functions and access to financial documents. The Fiscal Intermediary will process and adjudicate all FFS claims and prior authorizations

The new features impact FFS claims and prior authorizations; this implementation will not change managed care claims or prior authorizations submission processes.  

ODM has developed several resources to help you understand and prepare for the June 30 implementation. We encourage you to read and share the following:

• View the “Implementation Overview” to learn what this change means for providers and PNM users. This resource also includes information about where providers should go for questions about OMES submitted claims, prior authorizations, and other administrative processes.
• View the “Who to Contact for Help” document to learn who providers should contact if they need assistance.
• Review the “June 30 New Features Implementation Frequently Asked Questions (FAQ)” document for answers to some of the most common questions about the implementation.
• Review the “PNM module FAQ” document for more information on PNM functionality.
• Visit the Implementation Training and Resources page on the Next Generation website to learn more about training and see other available resources.

We appreciate your support of the Ohio Department of Medicaid as we take the next step in realizing the Next Generation program mission. 

For information on the planned system downtime between June 28, 5 p.m. to June 30, 3. p.m., read our "Upcoming planned system downtime" article below. If you are experiencing any technical issues, please contact Medicaid’s Integrated Helpdesk (IHD) at 800-686-1516 or IHD@medicaid.ohio.gov. The IHD is open Monday-Friday, 8 a.m.-4:30 p.m. Eastern time. 

** OAMES Note - The association will be meeting with ODM tomorrow to continue discussing and trouble-shooting issues DME providers are experiencing with the PNM system.  Members are advised to monitor OAMES ebulletins for any further updates.