Provider Carve-In Testing
Claims format testing for Re-Design and Carve-In begins March 1, 2018. Please see the documents below for instructions on how to register and other helpful tips to successfully complete claims format testing with Buckeye Health Plan.
Training and Live Q&A:
Providers are invited to join Buckeye staff for educational webinars on Behavioral Health Re-Design & Carve-In. Following the webinar sessions, there will be a open forum to answer any questions you may have regarding the new changes.
What Is Changing?
- Claim submission requirements will be changed.
- NCCI guidelines required for coding of services rendered. For detailed codes and descriptions see: Ohio Department of Medicaid - Provider Requirements and Reimbursement Manual (PDF)
- Requires NDC codes for all medications along with J codes
- Rendering providers must have a valid Medicaid Identification Number
- Rendering providers must have an individual NPI number
- To obtain an NPI go to: https://nppes.cms.hhs.gov/webhelp/nppeshelp/MAIN%20PAGE.html
- Rendering provider NPI must be included in all claims
- Claims submitted without the required information will be rejected or denied
Buckeye Health Plan is offering Webinars to help you understand all of these changes. These webinars will take place every Tuesday at 9:00am and every Thursday at 12:00pm starting on November 9th, 2017.**
**NOTE: There will be no Webinar held on Thursday, April 12th. We apologize for the inconvenience.
Join this Webinar via AdobeConnect - please use this link and the call-in details below for all orientation webinars
Conference Number: 855-351-5537
Participant Code: 663-181-7554
Please RSVP with the form at the bottom of the page at least TWO BUSINESS DAYS prior for the webinar that you would like to attend.
Buckeye Health Plan Welcomes Cenpatico Behavioral Health Providers.
Effective November 30, 2017, Cenpatico Behavioral Health, LLC (“Cenpatico”) will be assigning its Provider Agreements to Buckeye Health Plan. Cenpatico traditionally contracted with Behavioral Health Providers to provide Behavioral Health specific services. Along with the contracts, the management of certain Behavioral Health functions will also transition from Cenpatico to Buckeye Health Plan. This integration will unite best-in-class services under one name and will provide several benefits to members and providers, including:
- A fully integrated delivery model for medical and Behavioral Health services, supporting the needs of both members and providers.
- An enhanced member experience with centralized medical and Behavioral Health services and benefits to provide continuity in care.
- A streamlined approach to delivering service and support, with a single point of contact and benefits administration for providers.
If you have any questions, please call Provider Relations at 1-866-246-4356 ext. 24291.
For urgent needs, please email our rapid response inbox at BehavioralHealth@centene.com.
Join our Network:
If you would like to join Buckeye’s network, please click on the following link to access forms and information.
For information on Buckeye Health Plan products for new Behavioral Health providers, please view the video in the "All Products - New Provider Orientation" section of the Provider Training & Webinars page of our website.
Log in to the Secure Provider Portal:
As the Behavioral Health Redesign and Carve-In transition takes place, providers will need to maintain two log-in usernames and passwords – one for Medical and one for Behavioral Health member information.
- For Behavioral Health information, please log into the Cenpatico Secure Portal: https://provider.cenpatico.com/sso/login
- For standard Medical information, claims, etc., please log into Buckeye’s Secure Provider Portal: https://provider.buckeyehealthplan.com/sso/login
Please save the information for both Secure Provider Portals until the transition is complete in 2018.
- Ohio Provider Manual (PDF)
- Medicaid/Mycare Uniform Prior Authorization Form (PDF)
- Applied Behavioral Analysis (ABA) for Autism - Authorization Form (PDF)
- Electroconvulsive Therapy (ECT) Form - Medicaid (PDF)
- Electroconvulsive Therapy (ECT) Form - Medicare (PDF)
- Neuropsychological Testing Authorization Form - Medicare (PDF)
- Outpatient Treatment Request Form - Medicare (PDF)
- Outpatient Psychological Testing Authorization Form - Medicare (PDF)
- Community Mental Health Center Partial Hospitalization (CMHC PHP) Form - MyCare (PDF)