Ohio Medicaid Provider Network Management: Secure Access for Healthcare Providers

medicaid

The Ohio Department of Medicaid (ODM) Provider Network Management (PNM) module offers healthcare providers a comprehensive digital platform for managing critical healthcare administrative tasks. This secure online portal provides essential tools and resources for Medicaid providers across Ohio.

Official Portal Link

What Providers Can Do

The PNM module empowers healthcare providers with several key functionalities:

  • Access provider directory
  • Utilize provider search capabilities
  • Explore educational and training resources
  • Review fee schedules
  • Submit and manage cost reports
  • Manage prior authorization processes

Access and Authentication

Login Requirements

  • All users must log in using their OH|ID single sign-on credentials
  • Providers needing assistance can contact the ODM Integrated Help Desk

Provider Support

Integrated Help Desk

  • Phone: 800-686-1516
  • Email: [email protected]
  • Support Hours: 8 a.m. – 4:30 p.m. Monday-Friday (Eastern Time)

Recent Important Updates

Prior Authorization Changes

  • Effective August 1, 2025: Claims without approved prior authorization will be denied
  • Warning period currently in effect with detailed warning edits on remittance advice

Cost Report Transition

  • September 1, 2025: Online Cost Report Tool (OCRT) will replace Automated Cost Report Software
  • Providers must transition to the new web portal for cost report submissions

Training Opportunities

Provider Network Management Module

  • Training scheduled for August 19 – 28
  • Registration through Absorb Learning Management System
  • Recommended for providers needing module familiarization

Security and Compliance

User Responsibilities

  • Users are responsible for all activities under their account
  • Unauthorized access may result in account termination
  • All system activities may be monitored

Privacy Considerations

  • Confidential information access requires strict adherence to terms
  • Users must immediately report unauthorized information access
  • No expectation of privacy while using the system

Contact Information

Provider Enrollment and Assistance

  • Helpline: 1-800-686-1516
  • Mailing Address:
    Ohio Department of Medicaid
    Provider Enrollment Unit
    P.O. Box 1461
    Columbus, OH 43216-1461

Unprovided Information

The following details were not explicitly available in the source documents:

  • Detailed app download instructions
  • Specific billing portal features
  • Comprehensive step-by-step login process

The Ohio Medicaid Provider Network Management portal represents a critical digital infrastructure for healthcare providers, offering secure, centralized access to essential administrative tools and resources.

Disclaimer: Providers should always refer to the most current ODM guidelines and contact the Integrated Help Desk for the most up-to-date information.

FAQ

How do I check my provider enrollment status for Medicaid in Ohio?How do I check on the status of my application? Once an application has been submitted, you can go to the Medicaid Provider Portal to check the status. From the providers home page select the Registration ID of interest. Once you select the registration id link you will be taken to the ”Provider Management Home” page.

Does Medicaid have a portal?Our portal makes it easy to find what you need in just a few clicks. All members of Health Partners Plans Medicaid have access to the portal. Members with an existing account will need to re-register. We apologize for the inconvenience, however, this enables us to provide the best experience possible.

How do I check my Ohio Medicaid status?

AI Overview
  1. 1. Go to the Ohio Benefits Self Service Portal:

    Navigate to benefits.ohio.gov. 

      • Policy Matters Ohio
        https://policymattersohio.org
        Are you still covered by Ohio Medicaid? Check to be sure.
        Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

  2. 2. Log in or create an account:

    If you have an existing account, log in. If not, you’ll need to create one. 

      • Ohio Department of Medicaid (.gov)
        https://medicaid.ohio.gov
        Renewal Help
        If you don’t already have account, we encouraged you to create one as soon as possible at ssp.benefits.ohio.gov.

      • Policy Matters Ohio
        https://policymattersohio.org
        Are you still covered by Ohio Medicaid? Check to be sure.
        Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

  3. 3. Check your coverage details:

    Once logged in, you should be able to view your Medicaid coverage status, including whether you are currently enrolled and any relevant details. 

      • Policy Matters Ohio
        https://policymattersohio.org
        Are you still covered by Ohio Medicaid? Check to be sure.
        Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

      • Hamilton County Job and Family Services
        https://www.hcjfs.org
        Medicaid Resource Guide
        Visit www.healthcare.gov or www.benefits.ohio.gov to learn more, or contact HCJFS at (513) 946‐1000, option 3, and a second option 3.

      • Givers
        https://www.joingivers.com
        How to Check Your Medicaid Status
        Mar 25, 2024 — Many states have online portals where you can check your Medicaid coverage status. If you already created an account when you applied, log in to see…

  4. 4. Update your information:

    If you need to update your address or other personal information, you can do so through the portal. 

      • Policy Matters Ohio
        https://policymattersohio.org
        Are you still covered by Ohio Medicaid? Check to be sure.
        Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

  5. 5. Contact Ohio Medicaid if needed:

    If you have questions or need further assistance, you can find contact information on the Ohio Department of Medicaid website. 

      • Policy Matters Ohio
        https://policymattersohio.org
        Are you still covered by Ohio Medicaid? Check to be sure.
        Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

      • Anthem
        https://www.anthem.com
        Am I Eligible For Medicaid? | Ohio Anthem …
        You can check your eligibility online through the OH Medicaid website.

      • Hamilton County Job and Family Services
        https://www.hcjfs.org
        Medicaid Resource Guide
        Visit www.healthcare.gov or www.benefits.ohio.gov to learn more, or contact HCJFS at (513) 946‐1000, option 3, and a second option 3.

      • Cuyahoga County (.gov)
        https://hhs.cuyahogacounty.gov
        Medicaid Programs
        The Ohio Department of Medicaid has more information about programs and initiatives and information about services available on the ODM Website.

Is Ohio Medicaid the same as CareSource?Medicaid health care coverage is available for eligible Ohioans with low income, pregnant women, infants and children, older adults and individuals with disabilities. CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

https://medicaid.ohio.gov/resources-for-providers/welcomeproviders/welcome-providers

Use this page as a go-to resource for learning more about training, billing, rate-setting and additional areas of interest concerning the provider community.

https://ohpnm.omes.maximus.com/OH_PNM_PROD/Account/Login.aspx

All users must log in on the OH|ID portal using their single sign on ID. Attention Providers: if you need assistance signing in or acquiring your OH|ID, please

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