Medicaid

How to Get Credentialed with Ohio Medicaid in Ohio

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Ohio-Specific Requirements

Ohio Medicaid Managed Care enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the ODM (Ohio Department of Medicaid) MITS (Medicaid Information Technology System) provider enrollment portal. (3) Submit application with OH state license, proof of malpractice insurance, and required documentation. (4) Background check including BCI (Bureau of Criminal Investigation) and FBI fingerprint check is required for all providers. Ohio operates managed care through 6 MCOs covering the majority of Medicaid beneficiaries. Behavioral health providers accepted include LPCC, LISW, and LMFT with active Ohio licensure. Revalidation is required every 5 years.

Medicaid Information: Ohio

Agency: Ohio Department of Medicaid

Program: Ohio Medicaid

Portal: https://portal.ohmits.com

Phone: 1-800-686-1516

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Ohio.

2

Prepare Your Application

Complete Ohio Medicaid's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Ohio Medicaid.

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

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Required Documents Checklist

Background Check

BCI&I background check required

CV/Resume

Work history required

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

Ohio Medicaid Provider Enrollment (MITS)

Required
Online Open →

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to Ohio Medicaid.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-686-1516

Mon-Fri 8am-5pm

Provider Services

National

1-800-686-1516

Claims & Billing

National

1-800-686-1516

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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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