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PNM & Centralized Credentialing

Learn more about the Next Generation of the Ohio Medicaid program and what it means for providers, including available training.

Important Update

ODM has been and continues to be focused on implementing new Next Generation of Ohio Medicaid components and improvements as they are fully ready to support achieving our mission. ODM remains committed to listening to members, providers, and managed care plan partners, and we have taken a hands-on approach to resolving implementation issues that have been experienced by providers. ​Leading up to our next implementation, we have been actively seeking input from stakeholders and conducting testing of all systems.

Based on the feedback we have received and our commitment to carefully transitioning all components of the Next Generation of Ohio Medicaid, we will not implement the new Next Generation managed care plans and the full Ohio Medicaid Enterprise System (OMES) launch on December 1. The new lineup for implementation is as follows:

  • On February 1, 2023, ODM will launch the Next Generation managed care plans and program requirements, including exciting improvements that will support members in accessing the healthcare services and supports they need. ODM will also implement the new Electronic Data Interchange (EDI), increasing transparency and visibility of member care and services.
  • Subsequently, ODM will fully launch OMES modules to provide streamlined processes for claims, prior authorizations, and other administrative tasks for providers.

Providers should continue conducting business as you do today on and after December 1 – including the processes, procedures, and systems used today to submit claims, prior authorizations, and complete other administrative functions. In addition to this, PNM functionality will remain the same. ODM will provide more information about the upcoming implementation for members and providers in the coming weeks.

About the PNM module

Ohio Department of Medicaid (ODM) is excited to announce that the Provider Network Management (PNM) module went live on October 1! The PNM module serves as the single-entry point for secure portal functions such as claims submissions, prior authorizations, and member eligibility verification. Since October 1, providers are redirected from the PNM module to the appropriate MITS functionality.

What actions do I need to take?

  1. An OH|ID is required for providers to access the PNM module. If you do not have an existing OH|ID, you will need to create one to access the PNM module.
    • Access the PNM module by clicking here.
    • Click on the “Don't Have an Account Click Here” link on the PNM homepage. You will be redirected to the OH|ID site to create your new account.
    • If you need assistance or experience technical issues, contact the ODM Integrated Help Desk at 800-686-1516 or IHD@medicaid.ohio.gov.
  2. If you have an OH|ID or once you have created one, use your new OH|ID to log in to the PNM module by clicking here.
  3. Setup your Administrator & Agent roles in the PNM module. Remember, these will need to be reestablished in the PNM module. For more information, access the Agent Assignment & Actions Quick Reference Guide.

You are now able to access the features and functionality available in the PNM module. If you need technical assistance or encounter an error accessing the PNM, please contact the ODM Integrated Help Desk Command Center at 800-686-1516. If you have questions about OH|ID, please visit the OH|ID Help Center.

Getting help with module issues and questions

If you are having trouble with the PNM module, here are some helpful resources that you can use to resolve the most common issues providers are experiencing:

  • Identifying your role within PNM – Click this link for information on how to determine what role you are currently assigned to in the PNM module.
  • Agent Assignment & Actions – Click this link for information on how an Administrator can assign agent roles.
  • Finding Your OH|ID - Click this link for information on how to locate your OH|ID user ID number.
  • Enabling SMS Recovery for OH|ID - Click this link for information on how to enable SMS recovery for your OH|ID username or password.
  • Assigning Medicaid IDs to administer PNM module accounts – Call the Ohio Medicaid Integrated Help Desk at 1-800-686-1516 and select option 2, and then select option 3 to speak to a live agent. Call representatives will confirm provider credentials prior to updating the system. A call-back option is available. Additional information about this change can be found further down on this webpage.

Our next steps for resolving PNM module issues and reducing help desk hold times

We are working with our Maximus vendor to add additional help desk representatives as soon as possible to reduce wait times. We are adding additional staff to help answer your questions about establishing login credentials, navigating the PNM module landing page, affiliating providers with a role in the PNM module, and general PNM module-related questions. In addition, we are adding staff to support more complex provider questions, including re-connecting providers to the correct role if an incorrect role was previously selected, and advanced PNM module functionality questions.

The “Select Provider” button on the Provider Network Management (PNM) module has been disabled

Maximus has disabled the “Select Provider” button on the PNM. When available, this button allows provider administrators to obtain assignment of a Medicaid ID for their provider account.

We became aware of a potential security issue and are providing full support to Maximus as they work to correct the issue.

While this is being corrected, to assign Medicaid IDs to Administrator accounts in the PNM module, providers will need to call the Ohio Medicaid Integrated Help Desk at 1-800-686-1516 and select option 2, and then select option 3 to speak to a live agent. Call representatives will confirm provider credentials prior to updating the system. Representatives are available Monday-Friday 8 a.m. – 4:30 p.m.