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MyCare Ohio Resources

The Ohio Department of Medicaid has begun work on the development of the Next Generation MyCare program to expand statewide and implement some of the same program requirements and benefits as the Next Generation managed care program. We aim to provide Ohioans enrolled in MyCare Ohio a better healthcare experience, improve program transparency, and decrease administrative burden for providers.

In March, the MyCare Ohio team kicked off MyCare Ohio program community input sessions to hear provider experiences navigating the current Financial Alignment Initiative demonstration, and other Fully Integrated Dual-Eligible Special Needs plan (FIDE-SNP) models. Feedback collected during the community input sessions will inform efforts to prepare you for the changes coming to the MyCare Ohio program. Learn more about the MyCare Ohio program and community input sessions by reviewing the following resources: 

Learn more about the MyCare Ohio program by visiting the MyCare Ohio webpage on the Ohio Medicaid website. If you have questions or feedback about the Next Generation MyCare program, please contact MyCare Conversion Questions.  

HCBS Provider Training Modules & Reference Guides

MyCare Ohio Home & Community Based Providers Click here to join email listing for Updates, Notifications, Webinar Invites & Events.

Check Run Schedule Changes

To improve the timeliness and consistency of the claim payment process, Buckeye is adjusting the check run schedule. Beginning September 19, 2016, Buckeye’s twice weekly check run dates will occur as follows:

 MedicareMedicaid Waiver
CurrentTuesday & ThursdayWednesday & Friday
Effective Sept. 19, 2016Monday & ThursdayTuesday & Friday 

Keep in mind that this change would mainly effect transmissions submitted on a Sunday.

To further compliment timely payment contact PaySpan at (877) 331-7154 for electronic remittance and funds transfer capabilities.

MyCare Ohio Home & Community Based Providers Click here to join email listing for Updates, Notifications, Webinar Invites & Events.

Home Health Rate and Billing Changes

ODM announces changes to home health rates (PDF)

Buckeye MyCare Ohio Provider Job Board

The Buckeye MyCare Ohio Provider Job Board connects providers with members requiring services. By using this tool, Waiver Service Coordinators and Care Managers are able to post a secure, confidential notice that a member is in need of new or additional providers. Providers will be able to see these postings and apply as appropriate.

  • Job Board
  • FAQs
  • Job Board User Guide

Opting Out of Buckeye MyCare Ohio Medicare Coverage

MyCare Ohio allows for individuals to opt-out of Medicare coverage from the plan managing their MyCare Ohio benefits.

Providers need to confirm the MyCare Ohio member’s option for Medicare coverage. If a member chooses to Opt Out of Buckeye MyCare Ohio for their Medicare benefits, Buckeye will only manage Medicaid benefits, and will only reimburse claims for Medicaid services. Claims for Medicare must be submitted to the plan managing their Medicare benefits.

Therefore, it is important to verify member eligibility prior to each service rendered. Providers may use our secure Provider Portal on our website to check member eligibility, or call our Provider Services Department.

If your patient has chosen to Opt Out of the Medicare portion of MyCare OH, Buckeye Health Plan is managing the Medicaid benefits and will only reimburse claims for Medicaid services. A Prior Authorization for secondary payment from Buckeye is not required for the service(s) covered by their Medicare plan. Please submit the claim(s) to the plan managing the Medicare benefits (Medicare Fee For Service or Medicare Advantage Plan/Medicare Part C).