Buckeye Health Plan provides the tools and support you need to deliver the best quality of care. Please view our listing on the left, or below, that covers forms, guidelines, helpful links, and training.
For Ambetter information, please visit our Ambetter website.
- Manuals, Forms and Resources
- Eligibility Verification
- Prior Authorization
- Electronic Transactions
- Preferred Drug Lists
- Provider Training
- Advantage & MyCare Model of Care Training
- MMP Key Contact List (PDF)
- MMP Waiver Billing Code List (PDF)
- Durable Medical Equipment (DME) Provider Contact List for BP Monitors (PDF)
Provider newsletters are also available in hard copy upon request by calling Buckeye’s Provider Services department at 1-866-296-8731.
- Provider Report Summer 2019 (PDF)
- Provider Report Spring 2019 (PDF)
- Provider Report Winter 2019 (PDF)
- Provider Report Fall 2018 (PDF)
- Provider Report Summer 2018 (PDF)
- Provider Report Spring 2018 (PDF)
- Provider Report Winter 2018 (PDF)
- Provider Report Fall 2017 (PDF)
- Provider Report Summer 2017 (PDF)
- Provider Report Spring 2017 (PDF)
- Provider Report Winter 2017 (PDF)
- Provider Report Fall 2016 (PDF)
- Provider Report Summer 2016 (PDF)
- Provider Report Spring 2016 (PDF)
- Provider Report Winter 2016 (PDF)
- Provider Report Fall 2015 (PDF)
- Provider Report Summer 2015 (PDF)
- Provider Report Spring 2015 (PDF)
- Provider Report Winter 2015 (PDF)
- Ohio’s Immunization Registry and Reminder System
The Ohio Department of Health Immunization Program is a confidential, computerized information systems that provide a single source of immunization records for children. Information is entered at birth through a linkage with electronic birth records or at first contact with the health care system.
- Ohio Medicaid
Ohio’s Medicaid program provides health care coverage to children, pregnant women, families, seniors and people with disabilities who have limited income. The ODJFS Office of Ohio Health Plans is responsible for administering Ohio’s Medicaid program.
- The Official U.S. Government Site for People with Medicare
U.S. Department of Health and Human Services’ Web site featuring information about Medicare benefits, rights and protections and answers to the most frequently asked questions about Medicare.
- 2010-2011 Flu Information/Links for Physicians
In working to advance the health of the public and the preparedness of the medical community, the American Medical Association (AMA) and the Centers for Disease Control and Prevention (CDC) are committed to providing physicians with timely and credible information and resources about influenza. We encourage you to explore these web pages and check back regularly as new developments arise.
- Looking for more diabetes news? The following are links to sites that can provide you with more information about diabetes and how to help patients live better with it.
- The American Diabetes Association (ADA)
An organization dedicated to providing information and resources
- Juvenile Diabetes Research Foundation International (JDRF)
Provides diabetes news and support specifically targeted to people with juvenile diabetes.
- National Diabetes Information Clearinghouse (NDIC)
A service of the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), National Institute of Health (NIH), shares diabetes information for people with type 1 and type 2 diabetes, including news about diabetes management, diabetes complications and more.
- National Center for Chronic Disease Prevention and Health Promotion – Diabetes Public Health Resource
Provides information for the public and professionals, including research, education materials and key statistics.
- Medicare Website - Centers for Medicare & Medicaid Main Page – This is the link to the Main Page http://www.cms.gov/
- Medicare Claims Processing Manual – This link will give you the Claims Processing Guideline Manuals for all Medicare Services. http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS018912.html
- Medicare Transmittals – This link is for the Transmittals released from CMS which indicate changes that are being made across various areas of Medicare. http://www.cms.gov/Transmittals
- Medicare Fee Schedules – General information regarding Medicare Fee Schedules. http://www.cms.gov/FeeScheduleGenInfo/
- Average Sale Price Fee Schedule – This link will take you to the Average Sale Price for Part B Drugs Fee Schedule for current and previous years, regulations and notices and Average Sale Price Transmittals. http://www.cms.gov/McrPartBDrugAvgSalesPrice
- Ambulance Fee Schedule - This link will take you to the Ambulance Fee Schedule for current and previous years for all states, regulations and notices and Ambulance Fee Schedule Transmittals. http://www.cms.gov/AmbulanceFeeSchedule
- Ambulatory Surgery Center Fee Schedule - This link will take you to the Ambulatory Surgery Center Fee Schedules current and previous years, regulations and notices regarding ASC payment and supporting documentation for ASC Services. http://www.cms.gov/ASCPayment/
- Clinical Laboratory Fee Schedules - This link will take you to the Clinical Laboratory Fee Schedule for current and previous years, regulation and notices and Clinical Laboratory Transmittals. http://www.cms.gov/ClinicalLabFeeSched/
- Durable Medical Fee Schedule – This link will take you to the DME Fee Schedules current and previous years, federal regulations and Durable Medical Equipment Transmittals. http://www.cms.gov/DMEPOSFeeSched/
- Physician Fee Schedule – This link will take you to the Physician Fee Schedules for current and previous years, Federal Regulations, Carrier Specific Files, Relative Value Files, National Payment Amount file and Physician Transmittals. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/
- Acute Inpatient Facility Fee Schedule - This link will take you to the Acute Inpatient PPS System for current and previous years, wage index, outlier payments, regulations and notices, Acute Inpatient PPS Transmittals and Inpatient Prospective Payment System downloads. http://www.cms.gov/AcuteInpatientPPS/
- Outpatient PPS/APC Fee Schedule - This link will take you to the Outpatient Prospective Payment System or OPPS (APC) current and previous Fee Schedules, Regulation and Notices, Pass-through link, Addendum A and B updates and Outpatient Prospective Payment System Transmittals. http://www.cms.gov/HospitalOutpatientPPS/
- Home Health Prospective Payment System - This link with take you to the Home Health Prospective Payment System for current and previous years regulations and notices, coding and billing information, Home Health Transmittals and Home Health Agency Email Updates. http://www.cms.gov/HomeHealthPPS/
- Inpatient Psychiatric Facility Prospective Payment System – This link will take you to the Inpatient Psychiatric Facility Prospective Payment System for current and previous years, regulation and notices, tool and worksheets and Inpatient Psychiatric Prospective Payment System Transmittals http://www.cms.gov/InpatientPsychFacilPPS/
- Inpatient Rehabilitation Facility Prospective Payment System – This link will take you to the Inpatient Rehabilitation Facility Prospective Payment System, data files, software, research, Federal Regulations, Coverage requirements and Inpatient Rehabilitation Facility Prospective Payment System Transmittals. http://www.cms.gov/InpatientRehabFacPPS/
- Long-Term Care Hospital Prospective Payment System – This link will take you to the Long-Term Care Hospital Prospective Payment system wage index files, LTC-DRG files, Download section, Regulations and Notices, LTCCHPPS historical impact files, Training and Policy Fact Sheets, Elements of LTCHPPS and Long-Term Care Hospital Transmittals. http://www.cms.gov/LongTermCareHospitalPPS/
- Skilled Nursing Facilities Prospective Payment System – This link will take you to the Skilled Nursing Facilities Prospective Payment System will documentation regarding Swing Bed Providers, Wage Index, Consolidated Billing, Education and Training, Federal Regulation and notices and Skilled Nursing Facilities Transmittals. http://www.cms.gov/SNFPPS/