Provider Alert: Payspan Electronic Funds Transfer (EFT) Registration

Buckeye Health Plan’s electronic payment vendor, Payspan, recently encountered an issue with its user-account registration system. Currently, some of our providers are not able to obtain new registration codes or complete the process for electronic funds transfers. If you have tried to register a new account in the past several weeks, the registration may not have been completed due to this issue.

Once this issue is resolved, Payspan will re-activate its registration process and allow new provider users to register accounts to receive electronic payments. In the meantime, please continue to submit your claims, and you will be paid by Buckeye Health Plan for the care you are delivering. Payment method will be via a paper check.

We are sorry for any inconvenience this may have caused. Payspan is working aggressively to restore electronic payment functionality.

New Surgical Quality and Safety Management Program

Buckeye is pleased to announce the launch of a new and innovative Surgical Quality and Safety Management Program, effective February 15, 2018. The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Buckeye members undergoing Musculoskeletal Surgical Procedures. A notice was recently mailed to all affected providers.

Prior Authorization for medical necessity and appropriate length of stay (when applicable) has been delegated to TurningPoint Healthcare Solutions, LLC. and will be required for some surgical procedures in both inpatient and outpatient settings.

Please see the full letter with list of procedures and CPT codes below: 

• Surgical Quality and Safety Management Program - Provider Notice (PDF)
• Prior Authorization CPT Codes (PDF)

Member Care Management Review    

Providers, did you know that you can review your member's plan of care on Buckeye's Provider Portal? Log on to Buckeye's Secure Provider Portal to view this information along with member health risk assessment results as part of the electronic medical record. 

MyCare Long Term Care Program Changes

Beginning on November 1, 2017, new MyCare members who enroll in Buckeye Health Plan (Buckeye) will have their care managed by Buckeye’s RN Care Managers. The Buckeye Care Managers will communicate directly with you regarding the medical management of your patients as there will no longer be an Optum Nurse Practitioner assigned to your patient’s care. 

On January 1, 2018, the Buckeye Care Managers will assume care management responsibilities for all enrolled MyCare members residing in Nursing Facilities, and Optum Nurse Practitioners will no longer be responsible for the medical management of any MyCare members enrolled in Buckeye.

Buckeye is actively working on contracting with Nurse Practitioners throughout Ohio to provide medical management services to our MyCare members upon referral from the member’s physician and/or the Buckeye Care Manager. The Care Manager will notify you regarding referrals to the Nurse Practitioner for any of your patients. We appreciate the care that you provide for Buckeye’s MyCare members. We are available to discuss any questions or concerns with you. You can reach one of our representatives at 1-866-246-4358. Answers to frequently asked questions and other resources are also available on our website.

Buckeye Health Plan offers health insurance programs that fit the unique needs of our members.

View all of our available programs below. Select one to view more information and resources for our plan.