Behavioral Health Billing Solutions, LLC
The Ohio Department of Medicaid (ODM) and its Electronic Data Interchange (EDI) vendor, Deloitte, are inviting all trading partners to attend one of the two training sessions to learn about the Next Generation of Ohio Medicaid and changes related to EDI X12 exchanges. Any questions you may have prior to the training sessions should be submitted to firstname.lastname@example.org.
Please see below for the schedule of two-hour training sessions and where to register. Recordings of the trainings will be posted on the ODM website for those who are unable to attend during the scheduled times.
- Friday 10/28/22 from 10a-12p – click here to register
- Friday 11/4/22 from 10a-12p – click here to register
Trading partners must complete a Connectivity Form In order to begin submitting EDI transactions to Deloitte. If you have not completed a Connectivity Form, please contact email@example.com.
If your organization utilizes a clearinghouse to submit claims, you should reach out to your clearinghouse to ask what changes you may need to make in preparation for the 12/1 go-live.
Example Questions to ask your clearinghouse:
- Will your clearinghouse require us to submit different 837 files for each payer with the new payer ID at the ISA08? Or will your clearinghouse split out based on the payer ID we submit in the 2010BB loop?
- If your clearinghouse will split out, does the payer ID in the 2010BB loop need to be the new payer IDs listed in the companion guide? For example, if I send a claim with 31114 at the 2010BB loop for a date of service after 12/1, how will your clearinghouse react to this claim? Will I need to submit pre-12/1 date of service claims with 31114 and post-12/1 date of service claims with 0003150 at the 2010BB?
- If your clearinghouse will split out, will the ISA08 remain as it is currently set up or will there be any changes required?
- For any 12/1 or after claim, will we receive the snip 7 edits as payer rejections, or will there be clearinghouse edits in place to reject things like invalid 12 digit MMIS based on format? Are you adding any additional edits?
- Will your clearinghouse be doing outreach to send the 6306 835 designation form ODM06306fillx.pdf (ohio.gov) to clients who do not currently receive their FFS Medicaid 835s through your clearinghouse?
- Is there anything else we need to do to our files, billing configuration and/or ERA retrieval to prepare?
Thank you to our friends at The Ohio Council of Behavioral Health & Family Services Providers for sharing this information!