Provider Training & Webinars
Welcome to Buckeye Health Plan. We thank you for being part of our network of participating physicians, hospitals and other healthcare professionals.
Please see the drop-down menus below for one-hour webinar orientations that will cover information related to claims, authorization, web access, reference materials and key contacts at Buckeye Health Plan. Please choose a webinar that fits your schedule and corresponds to the Buckeye Health Plan product(s) you are contracted with. When you have completed the webinar or presentation, please fill out the form with your provider information and which webinar you have chosen to attend. An email confirmation will be sent once the form is submitted.
We are pleased to welcome you to our products and look forward to devleoping relationships that will improve the healthcare outcomes of our members and your patients.
If you have never attended an Zoom meeting before:
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Dr. Alvin D. Pelt, Behavioral Health Medical Director, Buckeye Health Plan, is pleased to present an important webinar for all substance abuse and mental health providers on ASAM criteria. At the end of this two hour presentation, you will be able to apply the ASAM Criteria to the length of stay for all levels of care by:
- Defining the Guiding Principles of the ASAM Criteria
- Identifying the Most Critical Step on the ASAM 7-Step Protocol
- Listing the 3 Factors used to determine LOC Placement
- Listing the 3 Components of the Continued Stay Criteria
CMS Medicare Training Requirement
CMS recently issued a requirement related to the settlement of the 2013 Jimmo v. Sebelius class action lawsuit. The settlement addresses the delivery of skilled nursing services to Medicare beneficiaries and applies to nursing facilities, home health and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met).
All Medicare providers are required to review this training in order to ensure that services are provided and coverage determinations are adjudicated accurately and appropriately in accordance with existing Medicare policy. Please click on the link below to access the training materials.
Beginning January 1, 2018, ODM is making significant changes to the management and administration of behavioral health services. These changes will impact all Ohio behavioral health providers, facilities and practitioners. It is critical for all providers to understand the changes and the actions require to ensure a smooth transition.
What Is Changing?
- Claim submission requirements will be changed.
- NCCI guidelines required for coding of services rendered. For detailed codes and descriptions see: http://bh.medicaid.ohio.gov/Portals/0/Providers/BH-Manual-Final-Version.pdf (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. Stay tuned for more information on how to register and attend these webinars.
Please click on the Zoom meeting link below and use the conference number and passcode to access Buckeye's general provider training for all our health plan products. These webinar orientations will be conducted every Wednesday at 4:00 PM EST.
Conference Phone Number: 1-646-558-8656 or 1-669-900-6833
Participant Code: 282-339-354
If you cannot attend these webinars or prefer to complete the orientation on your own time, please watch the video presentation below with voice-over narration.
Medical Providers - All Products Orientation
Behavioral Health Providers - All Product Orientation
Nursing Facilities Orientation
Effective 12/31/2018, the Ohio Department of Medicaid (ODM) and Buckeye Health Plan (Buckeye) will implement new signature requirement for MyCare waiver services. On and after that date, waiver service providers will be required to sign the individual’s person-centered service plan (service plan). This change meets the Centers for Medicare and Medicaid Services’ (CMS) 42 CFR 441.301 rule requiring the service plan “be finalized and agreed to, with the informed consent of the individual, in writing, and by all people and providers responsible for its implementation.”
The provider’s signature confirms that the provider acknowledges and agrees to provide the waiver service, as authorized in the waiver service plan. The signed service plan must be completed and returned to Buckeye to ensure timely payment for services. Requirements will vary depending upon the services provided.
Please watch the video presentation below with voice-over narration or view a PDF of the presentation.