Follow the steps to complete the OH ODM 07137 online.

1. Click ‘Get Form’ button to obtain the form. This will open the document in the online editor for you to begin filling it out.
2. Fill in the individual's name and qualifying treating physician's name in the designated fields at the top of the form. Also, provide their Medicaid billing numbers.
3. Complete Section I if the individual has not had an unrelated inpatient hospital stay. Check relevant boxes to certify the medical necessity for home health services.
4. If the individual has been discharged from a covered inpatient hospital stay, complete Section II by checking the boxes that apply regarding their condition and care requirements.
5. In Section III, if applicable, check the appropriate box regarding the individual’s discharge from an inpatient stay and provide the necessary certifications for private duty nursing services.
6. Ensure all fields that require signatures are completed, including the qualifying treating physician's signature and date for each relevant section.
7. Once you have filled out the form completely, save your changes. You can then choose to download, print, or share the form as needed.

Complete and submit your OH ODM 07137 form online for a streamlined process.