Web Content Viewer
Actions

OhioRISE Launch Information

On July 1, the Ohio Department of Medicaid (ODM) announced the launch of OhioRISE (Resilience through Integrated Systems and Excellence), Ohio's first-ever highly specialized program to help youth who have complex behavioral health and multisystem needs who are served by Medicaid. This page will provide you with updates on the OhioRISE launch and implementation.

What are ODM’s Launch Goals?

  • For children and youth to get the services they need.
  • For providers to get appropriately reimbursed for OhioRISE services rendered.
  • That as a state, we continue expanding local systems of care across Ohio. 

What are ODM's Goals for the OhioRISE Implementation?

  • OhioRISE members receive needed services. 
  • Children and youth and their caregivers in OhioRISE feel supported. 
  • Medicaid children and youth are able to receive a CANS assessment and be evaluated for OhioRISE eligibility. 
  • Providers are paid for services they render. 
  • Children’s services agencies and other community partners feel relief. 
  • The system of care for multisystem youth across Ohio continues to expand. 
  • Provide more home- and community-based services to reduce out-of-home placements.
  • Prevent custody relinquishment for children and youth with complex multisystem needs.

OhioRISE Launch Reports

The OhioRISE Launch Reports found below provide updates and highlights on the accomplishments, success stories, and impact of the OhioRISE program that week.

OhioRISE Enrollment Count

A Child and Adolescent Needs and Strengths (CANS) assessment is needed to help determine a child or youth's eligibility for OhioRISE. Click here for information about how to obtain a referral for a CANS assessment.

The below graph shows a weekly count of children and youth enrolled in OhioRISE since July 1, 2022. 

 

 

Member Helpdesks

Click here to download this information. 

Helpdesk Who Should Call? Types of Issues/Questions Supported
Medicaid Consumer Hotline
800-324-8680 (TTY 711)
  • 7 a.m. – 8 p.m. Eastern Mon.-Fri.
  • 8 a.m. – 5 p.m. Eastern Sat.
  • Current Ohio Medicaid members and/or their family members
  • Current OhioRISE members and/or their family members
  • Potentially eligible Ohio Medicaid members
  • Medicaid program eligibility and enrollment
  • Ohio Medicaid program benefits/services 
  • Selecting a managed care plan
  • Assistance finding an Ohio Medicaid provider, including nearby CANS assessors (to assist with determining eligibility for OhioRISE)
  • Issues receiving services from a Medicaid provider
Aetna OhioRISE Member Hotline
833-711-0773 (TTY: 711) 
24/7/365
  • This number automatically turns over to the 24/7 line after hours
  • Current OhioRISE members and/or their family members
     
  • OhioRISE program benefits/services
  • OhioRISE eligibility / how to enroll in OhioRISE / how to get a CANS assessment
  • Issues receiving services through the Aetna OhioRISE plan
  • Assistance finding an OhioRISE provider
  • Assistance contacting or receiving services from a CME
Managed Care Organization (MCO) Member Hotlines
Contact information and hours vary by MCO, information available at the bottom of the ohiomh.com homepage
  • Current Ohio Medicaid managed care members and/or their family members
     
  • Direct referral to a CANS assessor to obtain CANS assessment for OhioRISE eligibility (must make referral within 72 hours of request)
  • Value-add benefits / services provided by the MCO
  • Issues receiving services through the MCO
  • Assistance finding a provider contracted with the MCO
  • Non-Emergency Transportation not covered by a county department of job and family services (CDJFS)

Provider Helpdesks

Click here to download this information. 

Helpdesk Who Should Call? Types of Issues/Questions Supported
ODM Integrated Helpdesk (IHD)
800-686-1516
  • Provider Representatives: 8 a.m. - 4:30 p.m. Eastern Mon.-Fri.
  • Interactive Voice Response System (IVR) provides 24/7/365 access to information regarding client eligibility, claim and payment 
  • Current Ohio Medicaid providers
  • Current OhioRISE providers
  • Providers interested in enrolling with Ohio Medicaid
  • Using the CANS assessment tool and CANS IT system
  • Issues related to MITS
  • General Medicaid member eligibility questions
  • General Medicaid payment/billing questions and issues
  • Enrolling as an Ohio Medicaid provider
Aetna OhioRISE Provider Experience Help Line
833-711-0773 (option 2) 
  • 7 a.m. - 8 p.m. Eastern Mon.-Fri., excluding Aetna Better Health of Ohio holidays 
  • Current OhioRISE providers
  • Providers interested in contracting with Aetna
  • Contracting with Aetna / as an OhioRISE Plan provider
  • OhioRISE member claims, payment/billing questions and issues
  • OhioRISE member prior authorization 
  • Verifying a member’s OhioRISE eligibility
Managed Care Org. (MCO) Provider Hotlines
Contact information and hours vary by plan, information available at medicaid.ohio.gov/resources-for-providers/managed-care/provider-mcp-resources 
 
  • Current Ohio Medicaid providers contracted with the MCO
  • Providers interested in contracting with the MCO
  • MCO member claims, payment/billing questions and issues
  • MCO Prior Authorization for a member with the MCO
  • Verifying a member’s MCO eligibility
  • Contracting with the MCO

OhioRISE Implementation Office Hours

The OhioRISE implementation office hours provide opportunities for you to raise additional questions to OhioRISE subject matter experts to help implement and operationalize the program.

Family and Children First Council (FCFC) OhioRISE Office Hours

Meeting Date and Time Meeting Link

First Wednesday of every month from 4-5 p.m. through 2023.

 Click here to join

Developmental Disability System OhioRISE Office Hours 

Meeting Date and Time Meeting Link

Second Thursday of every month from 3-4 p.m. through June 8, 2023. 

 Click here to join

What’s Next for OhioRISE Implementation?

2023

  • OhioRISE will implement the new psychiatric residential treatment facility (PRTF) benefit to support children and families in Ohio.
  • At the end of year one, OhioRISE is expected to serve 50,000-60,000 children and youth. 
  • Development of OhioRISE services, care coordination, and the system of care will continue over the coming months and years.
Web Content Viewer
Actions