As a key part of Ohio Medicaid’s efforts to reimagine its managed care program and reduce administrative burden and redundancies throughout the future system, ODM will implement a centralized model for credentialing providers through the Centralized Credentialing project.
Once implemented, providers will only need to supply credentialing information once to ODM, rather than go through a separate credentialing process with each Ohio Medicaid managed care plan. Managed care organizations will not be able implement their own or a secondary credentialing process for Ohio Medicaid. They will, however, maintain control over their own business processes related to contracting of providers.
In addition to easing the administrative burden felt by Medicaid providers, Centralized Credentialing – along with the Medicaid Managed Care Procurement and Fiscal Intermediary – will provide ODM with access to higher quality, aggregated, and standardized data to inform quality improvement and oversight efforts.