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The Ohio Department of Medicaid (ODM) Next Generation Program — provider updates for October 1 launch
On October 1, ODM will launch the Provider Network Management (PNM) module and Centralized Credentialing, which will reduce administrative burden on providers. At the same time, 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.
In preparation for the launch of the PNM and SPBM, ODM is offering a variety of trainings. These trainings are a great opportunity for providers to gain knowledge that will benefit our members.
PNM trainings
ODM is offering several PNM training opportunities, which began August 1. Using the Learning Management System (LMS), Absorb, providers will be able to access self-paced training sessions and sign up for virtual and in-person learning. It is important that providers create an account, using the Job Aid, in the LMS to secure access to all training sessions, answer forms, and PNM resources in advance. Trainings will cover topics including:
- PNM login and access
- System navigation
- New enrollment applications
- Demographic updates
- Revalidations
SPBM trainings
ODM is also 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 by navigating to https://spbm.medicaid.ohio.gov and selecting 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
How can I learn more about the October 1 changes for providers?
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:
- Next Generation Ohio Medicaid Program Provider Overview Slides
- Next Generation Ohio Medicaid Program Provider Overview Recording
You can also check out the PNM & Centralized Credentialing and Single Pharmacy Benefit Manager (SPBM) webpages. For questions about the Next Generation program, contact ODMNextGen@medicaid.ohio.gov.
Please also subscribe to the ODM 2022 Press, ODM’s provider newsletter, to stay up to date on upcoming changes including more information about the Stage 2 and Stage 3 launches of the Next Generation of Ohio Medicaid.