01/23/2024
Important Reminders From Ohio Medicaid
Provider Revalidation – Medicaid Starting Terminations
Are you due to Renew?
The Ohio Department of Medicaid just sent out the following important update for physicians. Be sure to check your status.
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.
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 OHPNM@maximus.com 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.
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.
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 IHD@medicaid.ohio.gov. 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.
Remind your patients to check their Medicaid Coverage
Patient access to healthcare is critical to improving health outcomes. Starting last year when the Public Health Emergency that had expanded Medicaid eligibility in the pandemic expired, meaning that people covered by Medicaid must verify their eligibility or find a new health plan.
If you have patients on Medicaid, encourage them to make sure they know the steps they need to take to keep their coverage or find a new plan. The Ohio Department of Medicaid offers information and advice about renewal on their website at Medicaid.Ohio.gov or their hotline at (800) 324-8680. Additionally, CMS has created a new provider tool kit to assist practices in educating patients.