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Welcome to the Buckeye Provider Home Page

Being a trusted partner with our providers is a top priority. We must earn that trust every day, with every interaction. Based on your feedback, we have begun implementing a communication plan to enhance our provider messaging and communications. Please let us know if you have suggestions. 

Updates You Need to Know

  • June 28, 2022: Coverage of psychiatric or substance use disorder inpatient admissions for youth
  • June 16, 2022 - UPDATED State Fiscal Year-End Claims Submission and Provider Payments
  • June 21, 2022 Update to June 16, 2022 Practitioner Modifiers on Aetna OhioRISE Claims
  • June 15, 21022 Informational Update - Extension of Reimbursement to non-VFC providers
  • June 10, 2022 ODH Important Update on Infant Formula
  • OhioRISE May 18 Home and Community-Based Waiver Training video now available. 
  • June 21 - OhioRISE Training Module 4 -Local and Statewide Systems Engagement
  • May 18 - OhioRISE Home and Community-Based Waiver Training
  • Ohio Medicaid's Next Generation program to launch July 1 with OhioRISE

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Key Provider Information:

 

New Medication Adherence Tool

Data shows that out of every 10 of your patients, 3 are not taking their medications as prescribed. We’re introducing a new program, RxEffects, to assist in improving non-adherence for your Medicare Advantage patients. See more details.

Provider Services

Medicaid and MyCare Ohio

Monday - Friday / 8 a.m.-Noon 1-5p.m
866.296.8731

Wellcare by Allwell

Monday - Friday / 8 a.m.-Noon 1-5p.m
855.766.1851

Ambetter

Monday - Friday 8 a.m. - 5 p.m.
877.687.1189 

Portal Login

If you are a contracted Buckeye Health Plan provider, you can register now. If you are a non-contracted provider, you will be able to register after you submit your first claim. 

Once you have created an account, you can use the Buckeye Health Plan provider portal to: 

  • Verify member eligibility
  • Manage claims
  • Manage authorizations
  • View patient list
  • Login/Register

login/register

Provider Quick Links

PRE AUTH CHECK

SUBMIT CLAIM/CHECK CLAIM STATUS

PREFERRED DRUG LIST

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.

Health Insurance Marketplace

The Health Insurance Marketplace is an online shopping mall of healthcare plans. Buckeye Health Plan's plan is called Ambetter. Ambetter offers affordable health care coverage for individuals and families. Depending on  family size and income, a person may even qualify for help to pay their monthly premium.

Medicaid

Buckeye Health Plan is a care coordination plan contracted with the Ohio Department of Medicaid to serve Medicaid and other government services program members. Buckeye has developed the expertise to work with Medicaid members to improve their health status and quality of life.

MyCare Ohio

The Medicare-Medicaid Plan (MMP) is a joint effort between the Ohio Department of Medicaid (ODM) and the Centers for Medicare and Medicaid Services (CMS). Buckeye Health Plan – MyCare Ohio (Buckeye) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. The goal of this program is to improve the experience in accessing quality, coordinated care.

Medicare

Buckeye Health Plan Advantage is an HMO SNP plan with a Medicare contract and a contract with the Ohio Medicaid program. Enrollment in Buckeye Health Plan Advantage depends on contract renewal. This plan is available to anyone who has both Medical Assistance from the State and Medicare.

Provider Newsroom Prior to July 1, 2020

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