Welcome Providers

Ohio is home to more than 83,000 active Medicaid providers. The partnership between Ohio Medicaid and its provider network is critical in ensuring reliable and timely care for beneficiaries across the state. In the months ahead, this page will become a go-to resource for learning more about training, billing, rate-setting and additional areas interest concerning the provider community.

Episode of Care Reports Available on the MITS Provider Portal

This is a reminder, Episodes of Care Performance Reports are posted on the MITS Portal under the Report tab for Hospitals, Physicians, Group Providers, Clinics and Federally Qualified Health Centers. These reports show your cost of care per Episode, how your costs compare to your peers and should be shared with your Organization’s Leadership including your Medical Director/Quality Management. Your Portal Administrator has the role to view these reports. If you have questions about these reports or how to access them, call ODM Provider Services at 1-800-686-1516. (NOTE: Your practice/facility may not have Episode Reports if you did not have enough qualifying Episodes.)

Mandatory Waiver Provider Training

This notice is to inform all providers of services to individuals on an Ohio Department of Medicaid (ODM) home and community-based services waiver of mandatory training on incident management. An “incident” is an alleged, suspected or actual event that is not consistent with the routine care of, and/or service delivery to, an individual enrolled on an ODM waiver.

The mandatory training can be viewed at http://ohiohcbs.pcgus.com/TrainingMaterials/ In addition, upon entering into a Medicaid provider agreement, and annually thereafter, all providers must acknowledge in writing they have reviewed Ohio Administrative Code Rule 5160-45-05 Ohio department of Medicaid (ODM)-administered waiver program: incident management system, which can be found at http://codes.ohio.gov/oac/5160-45-05

Questions may be directed to ODM’s contracted Provider Oversight Contractor, Public Consulting Group (PCG) at 1-877-908-1746.