PNM Connectivity Issues
Important Alert: The Ohio Medicaid Enterprise System is currently experiencing intermittent connectivity issues. Users may experience delays or difficulties in accessing the Provider Network Management module. Technical teams are working diligently to resolve the issue as quickly as possible. We apologize for any inconvenience.
New features implemented in the Ohio Medicaid Enterprise System!
On June 30, the Ohio Department of Medicaid implemented new features in the Ohio Medicaid Enterprise System. Providers can now see and use these new features in the Provider Network Management module. To learn more about the benefits providers and Provider Network Management module users now experience, please review our email titled “New features implemented in the Ohio Medicaid Enterprise System” sent to providers from the [email protected] mailbox on July 1.
UPDATE! State Fiscal Year-End Claims Submission and Provider Payments
Medicaid provider claims submitted after 12 p.m., Friday, June 21, will be held for processing until Ohio Administrative Knowledge System (OAKS), the state’s accounting system, is up and running for state fiscal year (SFY) 2025, beginning July 1.
The Ohio Department of Medicaid anticipates issuing final provider payments for SFY 2024 on Thursday, June 27. For SFY 2025, fiscal year-end processing may cause a delay in payment until OAKS is up and running. The Ohio Department of Medicaid anticipates issuing the first payment of SFY 2025 to providers on July 8.
Please note, due to fiscal year-end processing and the July 4 holiday, OAKS processing may experience a brief delay and payments may not be made on July 8, as anticipated.
PERM RY2025 Update
The Payment Error Rate Measurement (PERM) 2025 Audit is in progress. If chosen, providers will receive a medical records request from the CMS review contractor, Empower AI. Please be advised that sampled providers who fail to cooperate may be subject to payment recovery by Ohio Medicaid Program Integrity. For more information on PERM visit: https://medicaid.ohio.gov/news.
Next Generation of Ohio Medicaid is implementing new OMES features! Here is what you need to know.
The Ohio Department of Medicaid (ODM) continues to implement new initiatives and improvements to achieve the program’s mission to focus on the individual and improve the provider experience. As an extension of this effort, we will implement new features in Ohio Medicaid Enterprise System (OMES) modules. Providers will see and utilize these new features in the Provider Network Management (PNM) module beginning on June 30, 2024. To learn more about the benefits providers and other PNM users will experience please read our implementation announcement.
IMPORTANT REVALIDATIONS UPDATE:
If you are currently due for a revalidation in the Provider Network Management (PNM) module, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. ODM will begin terminating providers who fail to complete their revalidation prior to their specified deadline, starting May 1.
Specialties Reminder
It is imperative that the pecialties page in the Provider Network Management module is accurate. This information is used for provider directories and sent to the managed care entities. For further details, view the ODM Press article.
Fee Schedules
You can access Ohio Department of Medicaid fee schedules on the Schedules and Rates page of the Ohio Medicaid website. You can also access them via the PNM home page, by clicking on the “Fee Schedule” tab and following the prompt to the hyperlink. Note: you do not need to be logged into PNM to access the “Fee Schedule” tab.
Ohio Department of Medicaid Rate Increases
Ohio Department of Medicaid (ODM) is pleased to announce the rollout of reimbursement rate increases, totaling $3.4 billion per year, effective January 1, 2024. This investment demonstrates Governor DeWine's commitment to support providers as they continue delivering the highest level of care for Ohio’s residents.
To learn more about the provider rate increases, including rate trackers and frequently asked questions, visit the ODM budget webpage on the Ohio Medicaid website. For additional assistance, providers can contact the ODM Integrated Helpdesk at 800-686-1516 or [email protected]. Representatives are available 8 a.m.-4:30 p.m. Eastern time, Monday – Friday.
Important: Revalidations Update
If you are currently due for a revalidation in the Provider Network Management (PNM) module, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. ODM will begin terminating providers who fail to complete their revalidation prior to their specified deadline, starting January 23, 2024. For further details, view the