A provider agency employs a Director of Operations, or DOO, and at least one other person that directly provides services to people with developmental disabilities. 

Among other requirements, provider agencies must submit: 

• A certificate of good standing from the Ohio Secretary of State demonstrating the agency provider’s status as a for-profit corporation, non-profit corporation, LLC, or LLP.
• Proof of an unencumbered line of credit in the agency provider’s name of at least $10,000.
• A certificate of general liability insurance of at least $1 million which includes coverage for individuals’ losses due to theft or property damage. 
• Proof that the agency provider employs a director of operations who meets the requirements outlined in the rule.
• Proof that in addition to employing a director of operations, the agency provider employs at least one other person to provide services.
• An employer identification number from the IRS.
• A certificate of policy from the Ohio Bureau of Workers’ Compensation.
• Proof that the agency provider is current in payment of payroll taxes, workers’ compensation premiums, and unemployment compensation premiums. 
• The name, country of birth, and social security number for any person having a financial interest of five percent or more in the agency provider.
• Written policies and procedures that address the agency provider’s management practices regarding the confidentiality of individual’s records, management of individual’s funds, reporting and investigation of major unusual incidents and unusual incidents, and documentation and billing for services. 
• The criminal records check by the Ohio Bureau of Criminal Identification and Investigation, and when applicable, by the Federal Bureau of Investigation, for the DOO.
• Certificate or transcript showing completion of the Director of Operations Orientation Training for Initial Certification located on DODD MyLearning. 
• A non-refundable application fee of $800 for agencies that serve 50 people or fewer or $1,600 for agencies that serve 51 people or more.

Agency DOO

Change in Agency DOO 

A change in the agency must be reported to DODD within 14 days. In Provider Network Management (PNM) you will need to create an update application for DODD. Once in the DODD application you will click on Update DOO and enter the new DOO information. The new DOO of an existing agency will need to map their PNM User ID to the agency’s DODD contract number. On company letterhead, include the name of the new DOO, the DOO’s new created PNM User ID, and the DODD contract number for the agency, signed by the agency owner or DOO. Email the document as an attachment to pnmsupport@medicaid.ohio.gov and include the below information.

Send an email to PNMSupport@medicaid.ohio.gov and include the following information.

1. Subject Line: Provider Admin Transfer

2. In the body of the email include the following information

   1. NPI

   2. Medicaid ID

   3. Provider Name (Independent First and Last Name, or Agency Organization Name)

   4. Last 4 of Tax ID

   5. Your OHID Username

   6. OHID User ID:

      • To obtain your OHID Federation ID go to OHID.ohio.gov

      • Enter your username and password

      • In the top right corner click on the person icon next to Log Out

      • The User ID should be listed here.

3. Include a document on company letterhead that states you are the Administrator for this record and make sure it has your signature.

Provider Agency Certification Process

Tips for a Smoother Process

	Start with the background check The 30-day review period for your application packet does not begin until all supporting documents are available for review, including background checks. Because the results of a background check can take up to 45 days, visit a WebCheck location for fingerprinting early in the process, while gathering additional documents and completing training.
	Provider Network Management (PNM) Module The PNM Module is the starting point for the provider certification application. Within this portal, you will be required to enter some basic information that will be shared with the Ohio Department of Medicaid (ODM). You will then be redirected to the PSM portal to complete your provider certification application.
	Consistency is key For consistency, always use the full name of agency and the DOO. Avoid abbreviating the agency name in PSM and when submitting required documentation.
	Choose services carefully In PSM, click Add Services to add services that the agency will provide. Click Withdraw Services and uncheck any service to end the agency’s certification for that service. Be aware that some services may require additional documentation.
	Check your work It sounds simple, but the most common reasons that applications are delayed for review include  documents missing a signature or date where one is required documents scanned and uploaded are too dark or too fuzzy for reviewers to read, or  the document title does not match the document that was scanned and submitted.