Ohio Application Service Provider Agreement
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How to fill out Application Service Provider Agreement?
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FAQ
The fee applies to organizational providers only; it does not apply to individual providers and practitioners or practitioner groups. The fee is a federal requirement described in 42 CFS 445.460 and in OAC 5160-1-17.8(C). The fee for 2022 is $631 per application.
First, you should open the following link: ?Ohio Medicaid Online Application? to access Ohio Medicaid's online application. From the main screen, you will need to select the ?New Provider? button located on the top right side of the home page screen. On the next screen you will be asked to select your application Type.
There are easy ways to find out which plan works with your doctor or specialist: Visit the Medicaid Consumer Hotline's website to search each MCP's directory. Call the Medicaid Consumer Hotline toll free 1-800-324-8680. Visit each plan's website for its provider directory.
Attach copies of your proof of income, resources (such as cash, savings, checking, real property, stocks, bonds, etc.), proof of citizenship or alien status, pregnancy if applicable, and other insurance you may have.
If you're a provider, call our Provider Hotline at 800-686-1516. If you're an Ohio Medicaid member, call our Consumer Hotline at 800-324-8680. Otherwise, follow the links below for additional resources, or complete the Contact Us Form and we'll get back to you. Where is my card?
After you have entered your basic demographic information, the system will issue you an Application Tracking Number (ATN). You should record this ATN immediately, because it will serve as your secure key to return to your application or to track it through the enrollment process.
Ohio is home to more than 165,000 active Medicaid providers.
Locating your. OH|ID User ID. ... Locating your OH|ID User ID. Number. Log in to OH|ID Account. Navigate to ohid.ohio.gov and log into your OH|ID account using your username and password. ... Locating your OH|ID User ID. Number. Retrieve your OH|ID User ID Number. ... 12345678.