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Ohio providers: Important updates to Medicaid claims processes and credentialing

February 2023

The Ohio Department of Medicaid (ODM) has recently changed some of their requirements for Medicaid claims submission:

  • Ohio Medicaid no longer accepts hard copy paper claims
  • All Medicaid providers are required to submit claims through:
  • All claims checks will be issued per health plan claims. For example, you will receive one check for Molina Medicaid, one check for UnitedHealthcare Community Plan, and one check for all other health plans (if applicable).
  • You will no longer be able to download an 835 payment file from Payspan®. You will need to register with ODM and get the file directly from the state. 
  • When submitting claims via clearinghouse:
    • UnitedHealthcare Community Plan Medicaid claims only – use Optum payor ID 83572
    • Molina Medicaid claims only – use Availity payor ID 0007316

As a reminder, on Oct. 1, 2022, ODM moved to a single, centralized provider credentialing process for providers. All provider enrollment applications must be submitted using the new PNM portal. The PNM portal is where providers can now complete provider enrollment, centralized credentialing, and manage provider self-service features. 

If you have questions about Ohio Medicaid provider enrollment, please contact ODM’s Integrated Help Desk (IHD) at 800‐686‐1516, Monday–Friday, 8 a.m.–4:30 p.m. You may also submit questions to the dedicated mailboxes: PNMCommunications@medicaid.ohio.gov or Credentialing@medicaid.ohio.gov.