This past month, the managed care plans have published updates on events and policy changes impacting their organizations.
Buckeye Health Plan:
Buckeye Health Plan has chosen Availity Essentials as its new, secure provider portal. Starting January 20, 2025, you can validate eligibility and benefits, submit claims, check claim status, submit authorizations, and access Buckeye Health Plans payer resources via Availity Essentials. Benefits for Buckeye members include:
- Use Availity Essentials to verify member eligibility and benefits, submit claims, check claim status, currently submit authorizations, and more.
- Look for additional functionality in Buckeye’s payer space on Essentials and use the heart icon to add apps to My Favorites in the top navigation bar. Our current secure portal will still be available for other functions you may use today.
- Access Manage My Organization – Providers to save provider information. You can then auto-populate that information repeatedly to eliminate repetitive data entry and reduce errors.
CareSource:
Ohio Department of Medicaid (ODM) recently updated provider directory data in the Provider Network Mangement (PNM) module. Please review your provider profile information to verify it is accurate. For more information, view this network notification.
As Respiratory Syncytial Virus (RSV) season is underway, CareSource is reminding providers of the medications available to prevent severe RSV during the newborn period. Click this link for more information about these medications.
Molina Healthcare:
Molina identified that some of their outgoing faxes have been unable to reach providers’ offices due to phone service providers blocking certain overflow fax numbers not public listed as Molina’s known numbers. This could impact the timely delivery of important patient care information and authorizations to some providers. Please verify any phone or fax number filters in place to not block unlisted numbers from Molina. A list of these numbers is available in the January 2025 provider bulletin.
Effective January 1, 2025, Molina, following ODM guidance, will no longer cover at-home COVID-19 test kits.
Molina’s updated Provider Manual has been released and can be accessed here.
United Healthcare:
United Healthcare’s 2025 Care Provider Manual is now available.