Credentialing & Patient Safety
Credentialing
The Ohio Department of Medicaid (ODM) is responsible for credentialing all Medicaid managed care providers. The credentialing and recredentialing processes are paired with enrollment and revalidation, respectively, in the Provider Network Management (PNM) system. This process adheres to the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS) federal guidelines for both processes and the types of providers who are subject to the credentialing process.
Please note, you are not able to render services to Medicaid members until you are fully screened, enrolled and credentialed (if required) by Ohio Medicaid. For a complete list of provider types that require credentialing, please refer to Ohio Administrative Code (OAC) rule 5160-1-42.
Patient Safety
Safe Clinical Practice
The Ohio Department of Medicaid (ODM) is responsible for credentialing all Medicaid managed care providers. The credentialing and recredentialing processes are paired with enrollment and revalidation, respectively, in the Provider Network Management (PNM) system. This process adheres to the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS) federal guidelines for both processes and the types of providers who are subject to the credentialing process.
Please note, you are not able to render services to Medicaid members until you are fully screened, enrolled and credentialed (if required) by Ohio Medicaid. For a complete list of provider types that require credentialing, please refer to Ohio Administrative Code (OAC) rule 5160-1-42.
Patient Safety
Patient Safety activities encompass appropriate safety projects and error avoidance for Molina Healthcare members in collaboration with their primary care providers.
Safe Clinical Practice
The Molina Healthcare Patient Safety activities address the following:
- Continued information about safe office practices.
- Member education; providing support for members to take an active role to reduce the risk of errors in their own care.
- Member education about safe medication practices
- Cultural competency training
- Improve continuity and coordination of care between providers to avoid miscommunication
- Improve continuity and coordination between sites of care such as hospitals and other facilities to assure timely and accurate communication
- Distribute research on proven safe clinical practices
Molina Healthcare also monitors nationally recognized quality ratings for facilities from the following groups:
*Printed copies of information posted on our website are available upon request.