Provider revalidations resumed; immediate action required

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 will resume on January 23, 2024.

All providers are subject to either three (3) or five (5) year time-limited provider agreements. Prior to termination, letters are both mailed and emailed 120 days, 90 days, 60 days, and a final notice at 30 days. Providers who do not submit their revalidation could experience termination at the state level, which would cascade to the Managed Care Entities (MCEs) causing claim denials as a non-participating provider. Emails will come from OHPNM@maximus.com.

Revalidations 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 the “Manage Application” then “Enrollment Actions” option within the provider file. Click the Revalidation/Reenrollment Quick Reference Guide 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 email IHD@medicaid.ohio.gov.

To learn more about the PNM module and Centralized Credentialing, visit the PNM and Centralized Credentialing page on the Next Generation website.