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Governor DeWine Announces Launch of OhioRISE, First-Ever …

WEBOhio Governor Mike DeWine today announced the official launch of Ohio Resilience through Integrated Systems and Excellence (OhioRISE), a new Ohio …

Actived: 4 days ago

URL: https://managedcare.medicaid.ohio.gov/news/news-all/press-release-07012022

Ohio Medicaid Managed Care

WEBIf you receive a call, email, or text about your Medicaid benefits that ask for payment, banking, or credit card information, please ignore. These are NOT generated by the …

Category:  Health Go Health

OhioRISE care coordination overview

WEBLast updated: January 23, 2023 1 . OhioRISE care coordination overview . What is OhioRISE? OhioRISE (Resilience through Integrated Systems and Excellence)is a …

Category:  Health Go Health

Next Generation Managed Care Benefits

WEBCommunity investment: Together, with the Next Generation managed care plans, Ohio Medicaid is investing in the local communities where members live by working with …

Category:  Health Go Health

About OhioRISE Ohio Medicaid Managed Care

WEBAbout OhioRISE. OhioRISE aims to shift the system of care and keep more kids and families together by creating new access to in-home and community-based services for …

Category:  Health Go Health

Ohio Department of Medicaid Announces Six Partners to Further …

WEBOhio Department of Medicaid Director Maureen Corcoran today announced the selection of six health care organizations to lead the department’s evolution of …

Category:  Health Go Health

Resources for Community Partners and Providers

WEBOhio Department of Medicaid (ODM) holds office hours for community partners and providers to raise questions to OhioRISE subject matter experts to help ongoing …

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OhioRISE Frequently Asked Questions

WEBUpdated July 26, 2021 *This FAQ will continue to be revised as the services and components of the program are being developed and all responses are subject to change.

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Provider Contracting Information

WEBAll pharmacies will have to contract with Gainwell to provide pharmacy services for Medicaid managed care members. For pharmacy contracting questions, Gainwell may …

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Submitting Claims and Prior Authorizations

WEBAs of October 1, 2022, the Single Pharmacy Benefit Manager (SPBM) is the entry for pharmacy claims and prior authorizations for managed care members. This does not …

Category:  Health Go Health

OhioRISE (Resilience through Integrated Systems and Excellence)

WEBAs a part of Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM has launched OhioRISE (Resilience through Integrated Systems and Excellence), …

Category:  Health Go Health

Provider Enrollment and Specialty Addition Guidance for

WEB9/2/2022 1 . Provider Enrollment and Specialty Addition Guidance for OhioRISE Behavioral Health Respite Services Behavioral Health (BH) Respite provides a short-term …

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Resources for Prescribers, Pharmacists, and Pharmacy Support …

WEBAs of October 1, 2022, ODM SPBM, Gainwell Technologies, is responsible for managing pharmacy services including a specialty pharmacy program for all Medicaid managed …

Category:  Health Go Health

Credentialing Guide and Requirements

WEBCredentialing Requirements – Individuals. The following are required for all individual providers: CAQH Form. Licensure in the state from the state where you practice. …

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OhioRISE Provider Enrollment and illing Guidance

WEBThe most recent version of this guidance may be found at the OhioRISE Resources for Community Partners and Providers Website. ii OhioRISE Provider …

Category:  Health Go Health

Ohio Medicaid Open Enrollment FAQ

WEBA “Just Cause” is a request to change or disenroll from a plan outside of the annual open enrollment period or initial 90-day period after enrollment. If you have questions on what …

Category:  Health Go Health

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