SPBM

Gainwell Portal

Gainwell Call Center
Phone: 833-491-0344 (TTY 1-833-655-2437)
Fax: 833-679-5491

Single Pharmacy Benefit Manager (SPBM) ODM website. 

For questions about the Next Generation program, contact ODMNextGen@medicaid.ohio.gov.

On October 1, the Single Pharmacy Benefit Manager (SPBM) will begin providing pharmacy services across all managed care plans and members.

To prepare for these changes, providers should set up their OH|ID and associate their existing accounts. The OH|ID Pre- registration site is available through September 23 and can be found at: https://pnm-preregistration.omes.maximus.com. The OH|ID is necessary for anyone that will access the PNM or SPBM modules. Establishing login credentials during Pre-registration will ease the transition and prevent disruptions to system access for providers ahead of the October 1 launch.

Additional Reference Materials

In July, ODM hosted a webinar for providers on the Next Generation's Stage 2 October 1 launch. This webinar included an overview of the new modules and upcoming provider training plans and dates. Please see below for a recording of the session and the corresponding slides.

• Next Generation Ohio Medicaid Program Provider Overview Slides
• Next Generation Ohio Medicaid Program Provider Overview Recording

SPBM Trainings

ODM is offering several SPBM training opportunities, which will begin September 6. Training is offered via online instructor- led webinars, recorded online training, and weekly Q&A forums. Registration for training is now open. Registration instructions are available, just select the Provider tab. Trainings will cover topics including:

• SPBM login and access
• System navigation
• Verifying member pharmacy benefit eligibility
• Submitting and viewing pharmacy claims
• Submitting and viewing pharmacy prior authorizations