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MANAGED CARE RESOURCES
While governed by Ohio Medicaid and Ohio Laws, the Medicaid Managed Care Plans operate independently and their business processes are all slightly different.
It is imperative that the business office be familiar with each plans’ requirements for doing business to be paid accurately and timely.
MANAGED CARE RESOURCES
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Connections for Better Care:
Inpatient Psychiatric Episode Care Coordination Project
A recommended best practice is that the HOSPITAL, MCP and Outpatient Providers identify a single point of contact/email distribution group. Formally documenting and providing additional specification to the expectations above would be advisable as well. Additionally, at all stages of the inpatient episode MCP representatives, Community BH Provider treatment staff, and actively involved Family Caregivers need to be allowed on-site at the inpatient facility to engage with the patient and staff of the facility.
OBHPN is proud to partner with Ohio's Managed Care Organizations and Ohio's free-standing psychiatric hospitals toward an improved patient experience and coordination of care which will lead toward optimal patient outcomes.
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Below are links to add your information to our directories!
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As a member of OBHPN, your agency can optimize patient care and business office performance through several network-based benefits:
STATE LEVEL RESOURCES
Ohio’s Behavioral Health Redesign Website
Stay current on how to do business with the state and the associated Ohio Medicaid managed care plans. The Redesign Website provides the most current Provider Manuals and Resources for Behavioral Health Providers working with the state.
Newsletters distributed by the Ohio Department of Medicaid contain details around upcoming changes and educational opportunities. The Behavioral Health MITS Bits contains information on topics directly associated with Ohio Medicaid's Behavioral Health Redesign initiatives and related changes which became effective January 1, 2018 and Managed Care Carve-In, which was effective July 1, 2018. Sign up to receive them right in your mailbox!
The Ohio laws which govern the behavioral health managed care program are a good point of reference when questioning plan policy or implementing new policies within your organization.
The Ohio Department of Mental Health and Addiction Services is the state agency that regulates and supports mental health and addiction providers. Their authority resides in the Ohio Revised Code under Chapter 5119 and they promulgate rules under Ohio Administrative Code Chapter 5122. They work closely with the Mental Health Boards and ADAMH Boards at the county and regional levels.
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Ohio Medicaid Managed Care Plan Agreement
This agreement governs the relationship between the state and the Medicaid Managed Care Plans. It outlines their responsibilities and obligations. Being informed about what the plans are held accountable for can help encourage an open discussion about operational and contractual discrepancies.