This past month, the managed care plans have published updates on events and policy changes impacting their organizations.
Ohio Department of Medicaid:
The Ohio Department of Medicaid (ODM) is offering new coverage to help more Ohioans with mental health needs. The new mental health peer support service connects trained, certified peer supporters who are in recovery with people seeking support for similar conditions. The approach is designed to complement the role therapists, social workers, and other behavioral health specialists serve in the treatment and recovery process. Click here to learn more.
Medicaid fraud warning: Criminals are targeting Medicaid recipients for sensitive, personal, and financial information. If you get a call, text, or email about Medicaid benefits that ask for Social Security Number, payment, bank, debit, or credit card information, do not respond. The communications are not from the State of Ohio or any agency. Instead, report it to the Ohio Attorney General by calling 800-282-0515 or visiting this website.
AmeriHealth Caritas:
As of 8/29/24 providers can now submit a dispute with attachments to AmeriHealth Caritas Ohio via NaviNet. To access, go to the Plan Central Home page, Forms and Dashboards and select Provider Disputes.
AmeriHealth Caritas Ohio is accepting ANSI 5010 ASC X12 275 claim attachment transactions (unsolicited) via Availity. Please contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic 275 claim attachment transaction submissions for payer ID: 84243. Click here to learn more.
Buckeye Health:
Suicide is not inevitable for anyone. Providers play a powerful role in early identification of at-risk individuals. In fact, primary care is a critical point of contact for those contemplating suicide with 77% of people having seen their primary care provider within the year prior to their death and 45% within the month prior. To help combat this unnecessary loss of life, Buckeye Health Plan is offering a free accredited continuing education course titled “Identifying and Supporting Individuals at Risk for Suicide.”
CareSource:
CareSource has partnered with Versant Health to cover Vision Services for Ohio Medicaid CareSource members. To learn more, click here.
Humana Healthy Horizons:
Humana has a new search tool to help providers streamline prior authorizations! Providers can now search by CPT code, procedure, or drug name to determine if authorization is required. Providers can also find guidance on how to submit medical and pharmacy authorizations. Access the tool here.
Molina Healthcare:
Molina is offering the chance to enter a monthly drawing for a prize! To enter, join a provider training and share your name and email. Click here to learn more.
United Healthcare Community:
As of October 1, 2024, United Healthcare will be removing email as an intake option to maintain demographic data for groups and practitioners. UHC will be no longer be accepting email as a method to update your information. Moving forward, groups and practitioners can submit their demographic updates through one of the following methods listed here to ensure timely and accurate updates of your data.