Provider Enrollment

 Important Enrollment Update  

Provider Revalidation Begins in Ohio

The Affordable Care Act (ACA) requires all Medicare and Medicaid providers to revalidate their provider enrollment information at least every five years.  Even before the passage of the ACA, Ohio initiated a similar requirement for nearly all Ohio Medicaid providers.(See OAC 5101:3-1-17.4)  Beginning in April, 2013, Ohio will begin revalidating a limited number of providers and will expand the effort to all providers over the coming months.  Providers will receive notification letters with instructions for revalidating 90 days before their revalidation deadline. Providers should not take any steps to revalidate until they receive their notification letters. Providers that do not revalidate will be terminated from participation in the Ohio Medicaid Program. Additional information on revalidation.

Important notice to providers that have received revalidation letters:  The Office of Medicaid Assistance is aware of an issue regarding a provider's ability to sign-in to their Revalidation Application.  If you are an organization or group, you must sign using name as it appears on your Revalidation notification letter. 

If you are an individual, you will most likely have to use your full name, not just your last name as prompted. Your full name is on your letter. For instance: Silver Joseph J MD.  Be sure not to use your business address or you DBA name as your name.  If you should exit the program prior to completing your Revalidation application, when you sign on the next time, your new log-in might be just your last name. 

Once you have entered the business name or your individual name, you must select "search" before you select the "next" button.  

Enrollment process for Ohio Department of Aging providers

If you are interested in applying to become a provider for the Choices, PASSPORT or Assisted Living Medicaid waiver programs, please go to http://aging.ohio.gov/resources/providerinformation to start your application. If you have any questions regarding certification for these programs, please contact 614-644-1737.

02.04.2013 - Provider Enrollment Application Fee   

Effective March 1, 2013, Ohio will start collecting a non-refundable application fee upon initial application to enroll as a Medicaid provider and also every 5 years at the point of revalidation.  PLEASE NOTE:  

• The fee applies to organizational providers only; it does not apply to individual providers and practitioners or practitioner groups.   
• The fee is currently $532 per application and it will increase annually for inflation.  The fee is set by the Centers for Medicare and Medicaid Services (CMS). 
• This fee is an application processing fee and will not be refunded if your application is denied or if it is returned to you as not processed due to being incomplete. 
• Applicants who are enrolled as Medicare providers or in another state as a Medicaid provider, and have paid the associated fees to either program, will not have to pay it again to enroll as an Ohio Medicaid provider.  However, applicants who indicate this must submit proof of payment with their application. 
• There may be further clarification from CMS about the acceptable timeframes to be excused from paying the fee if the provider has already paid to Medicare or another state's Medicaid.  Ohio Medicaid will provide additional information about this as it becomes available. 
• The fee is a federal requirement.  Please see 42 CFR 455.460 Application Fee and/or OAC 5101:3-1-17.8(C) for more information about the fee.   

Background Checks Required for Ohio Home Care Providers 
Non-agency Ohio Home Care waiver providers (personal care aides, home care attendants, nurses and other waiver service providers) are required to have a criminal background check conducted by the Bureau of Criminal Identification and Investigation (BCI&I). If you have lived in Ohio for at least five years, you are required to have only an Ohio criminal background check. If you have lived in Ohio for fewer than five years, or if you were convicted of a crime in another state,  you must request both an Ohio background check and a FBI background check.  The results of your background check must be submitted DIRECTLY to ODJFS from BCI&I to the address below. Background checks submitted to us by the Webcheck vendor, local law enforcement agencies, the applicant, or any entity other than BCI&I can not be accepted. You must provide the address below to the Webcheck vendor when you have your background check completed:

ODJFS
Attn: BCI&I
PO Box 183017
Columbus, Ohio 43218-3017

To obtain a background check, you must go to a location that performs electronic WebCheck background checks for submission to BCI&I. A listing of WebCheck agencies can be found on the Ohio Attorney General's website at the following link: WebCheck Community Listing. You may also contact BCI&I by telephone at (877)224-0043.

Direct Deposit  

To receive payments via direct deposit, please complete the Direct Deposit Authorization Agreement.

For additional information please contact:
Provider Enrollment Unit
P.O. Box 1461
Columbus, Ohio 43216-1461