AdministrativeMedicaid Managed CareSeptember 1, 2024

Provider revalidations

A message from the Ohio Department of Medicaid

The Ohio Department of Medicaid (ODM) resumed provider revalidations in June 2023. It is imperative that providers who are due for revalidation take immediate action, as terminations resumed January 23, 2024.

All providers are subject to either three- or five-year, time-limited Provider Agreements. Letters are mailed and emailed 120 days, 90 days, and 60 days prior to termination, and a final notice is sent 30 days prior to termination. Providers who do not submit their revalidation could experience a termination at the state level — which would cascade to the managed care entities (MCEs) and cause claim denials as a non-participating provider. Emails will come from OHPNM@maximus.com.

Revalidation notices are posted in the Provider Network Management (PNM) module and can be accessed in the Correspondence folder. Providers will also see a Begin Revalidation option in the PNM Enrollment Action Selection 120 days prior to the Medicaid Agreement end date. Providers can locate this under Manage Application > Enrollment Actions within the provider file. Refer to the Quick Reference Guide: Revalidation/Reenrollment (maximus.com) for step-by-step instructions.

Providers who need technical assistance can contact ODM’s integrated help desk at 800-686-1516 and follow the prompts for provider enrollment, or providers can email IHD@medicaid.ohio.gov.

To learn more about the PNM module and centralized credentialing, visit the PNM & Centralized Credentialing page (ohio.gov) on the Next Generation Program website (ohio.gov).

Anthem Blue Cross and Blue Shield Medicaid is the trade name of Community Insurance Company. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

OHBCBS-CD-060523-24, OHBCBS-CD-060525-24, OHBCBS-CD-060526-24

PUBLICATIONS: September 2024 Provider Newsletter, November 2024 Provider Newsletter