Need a Prior Authorization?
PA Lookup tool is under maintenance.
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Recent Updates
ODM News:
EDI (Electronic Data Interchange) Inquiries: Per the Ohio Department of Medicaid (ODM), trading partners should direct all EDI questions and concerns through the Ohio Medicaid Enterprise System (OMES) EDI Help Desk at OMESEDIsupport@Medicaid.ohio.gov or by calling (800) 686-1516.
IMPORTANT UPDATE: Per ODM, terminations resumed on Jan. 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management (PNM) module. If you are currently due for a revalidation in the PNM module, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. Find additional information on the ODM PNM & Centralized Credentialing page, under the "Important update: Terminations to resume effective January 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management module" header.
Molina News:
The Prior Authorization (PA) Code Updates by line of business, effective April. 1, 2024, are posted here under the “Prior Authorization Code Changes” header. Please utilize the PA Code LookUp Tool to search for codes that require PA.
The Medicaid Provider Manual, effective as of Jan. 1, 2024, is posted here.
The MyCare Ohio Provider Manual, effective as of Jan. 1, 2024, is posted here.
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For more information call (855) 665-4623, TTY/TDD: 711, Monday - Friday from 8:00 a.m. - 8:00 p.m. local time and ask for our Care Management department.
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