ICF-IID Billing Changes: Attending Physician Requirement

Recently, the Ohio Department of Medicaid (ODM) issued a new requirement regarding claims submission that will affect ICF-IID claims beginning July 1, 2015, when direct bill begins.

What's changing?

To bill claims to MITS for payment of services, the exact name and identification number of an Attending Physician must be included on the claim. The Attending Physician must be a provider enrolled with ODM, either as an ORP-only (Ordering, Referring, or Prescribing) provider or a full Medicaid billing provider.

Who can be an ORP-only provider?

 Only certain medical practitioners are eligible to be ORP-only providers; this includes Physicians, Advanced Practice Registered Nurses (APRN), Physician Assistants, Dentists, Optometrists, Podiatrists, Psychologists, or Chiropractors.  

What do I need to do?

ICF-IID providers should act now to make sure they have an Attending Physician appropriately enrolled with ODM to ensure claims can be submitted and paid. Learn more about how to become a full Medicaid billing provider or an ORP-only provider on ODM's website. There will be an option for "enroll as a provider to bill Ohio Medicaid," or "enroll for the sole purpose of Ordering, Referring, or Prescribing."

For more information regarding the new requirements, visit the ODM provider page.

Where can I get more information?

ODM will send updates about training, training manuals, and other specific billing requirements. DODD will share updates via email, and post them on the ICF-IID Billing Changes page of DODD's website.

For questions, contact Josh Anderson at Joshua.Anderson@dodd.ohio.gov.