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March 28, 2024
April 2024 Managed Care Plan Updates

This past month, the managed care plans have published updates on events and policy changes impacting their organizations.

Ohio Department of Medicaid: 

Interested in learning more about the Comprehensive Primary Care (CPC) Kids program managed by the Ohio Department of Medicaid? An overview of the program, activity requirements, and metrics can be found here. You may also visit this link for previous webinars and register here for upcoming webinars.

 

AmeriHealth Caritas: 

Change Healthcare, the electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. For most recent updates, visit this link.

 

CareSource: 

The CareSource Behavioral Health Provider Relations team will continue to offer CareSource Connections throughout 2024, their monthly operational engagement platform consisting of education and training topics specific to Ohio behavioral health operations. View the upcoming education and training schedule here.

CareSource has also updated its Provider Claim Submission feature in their portal. To learn more or submit questions, please click here.

 

Humana Healthy Horizons: 

Due to a security breach, Change Healthcare cannot currently be used to submit claims for Humana Healthy Horizons. Availity has provided guidance for providers to connect with them directly for various uses. Click here for more information.

 

Molina Healthcare: 

A critical outage of third-party vendor Optum-Change Healthcare is impacting electronic claims submission, payment and settlement services. For alternative options, please click here.

 

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