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On June 30, the Ohio Department of Medicaid (ODM) implemented new features in the Ohio Medicaid Enterprise System (OMES). ODM provided OSMA the following update to send to our members:

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Providers will see and use these new features in the Provider Network Management (PNM) module.

What you need to know about the June 30 Implementation:

The new OMES features in the PNM 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 now processes and adjudicates all FFS claims and prior authorizations. Providers and PNM users can now:

• Complete direct data entry for FFS claims and prior authorizations, conduct claims searches, and complete other administrative activities in the PNM module without being rerouted to the Medicaid Information Technology System (MITS).
  
  
• Complete claim adjustments and voids in the PNM for any FFS claims, whether they are submitted by direct data entry in the PNM or by a trading partner in the Electronic Data Interchange. 
  
  
• Receive one remittance advice for FFS claims whether they are submitted by direct data entry in the PNM or by a trading partner via the Electronic Data Interchange. 
  
  
• Find future 1099 forms and other financial documents in the PNM without needing to call the Integrated Helpdesk (IHD). To retrieve 1099 forms for past tax years providers will need to call the IHD.
  
  
• Look up member eligibility within the PNM, rather than being rerouted to MITS, which streamlines and simplifies the process.
  
  
• Look up hospice enrollment within the PNM, rather than being rerouted to MITS.

The new features impact FFS claims and prior authorizations. There are no changes to managed care claims and prior authorizations as part of this implementation.

Linked below are a variety of resources you can use to spread the word and guide providers who have questions:

• View the June 30 New Features Implementation Overview document to learn what this change means for providers and PNM users. This document 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. Most questions about this implementation should be directed to the IHD at (800) 686-1516.
  
  
• 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.