Ohio Medicaid Managed Care Provider Agreement

If a vendor application requires additional support documents from the department for the completion of the application process, support documentation can be sent to the service via the MITS web portal or by regular postal service. A provider agreement is a contract between the Ohio Department of Health Services (ODM) and a provider of medicaid covered services. By signing this agreement, the supplier undertakes to abide by the terms of the supplier agreement, the revised code, the administrative code and federal laws and rules; and the provider certifies and agrees: Managed care plans behave like regular health insurance. Once you are enrolled in a managed care plan, you should receive a new card in the mail. In Ohio, most people who have Medicaid have to join a managed care plan to receive their health care. The managed car plans are licensed health insurance funds from the Ohio Department of Insurance that have a vendor agreement with the Ohio Department of Medicaid to provide coordinated health care to Medicaid beneficiaries. These managed care plans work with hospitals, doctors and other health care providers to coordinate care and provide available health care with an Ohio Medicaid card. A valid supplier agreement with medicaid is considered a supplier agreement for participation in the medicaid program. All requests from health service providers must be submitted via the Medicaid Information Technology System (MITS) web portal.

Applications from a paper-based supplier are returned to the supplier without being processed. Once approved for Medicaid, you will receive information in the email that will help you choose a managed care plan. You have the option to modify managed care plans during the registration process opened each year in November. 6. Can my parent/spouse or someone else speak for me with the managed care plan? The provisions of the benefit agreements for care facilities are defined in section 5160-3 of the administrative code. Chapter 5160-26 of the Administrative Code provides provisions for provider agreements for Medicaid contracts for managed care plans. For more details on these programs, please see: 5. How often do you receive a new Medicaid Managed Care Plan?.

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