Information and Resources on Managed Care for LTC Providers
MyCare Ohio Rules
Updated enrollment timeline, including map of the different regions
MyCare Ohio Plan Resources
Care Management and Patient Liability Information Table
The Care Management and Patient Liability Information Table provides information for each plan in relation to specific care management and billing procedures related to patient liability. For Care Management, the table covers how to acquire a prior authorization for a skilled service without a 3-day hospital stay and care management practices for the assisted living setting. The Patient Liability table covers the PL source of data, placement on SNF and AL claims, and how to bill lump sum. We believe this information to be accurate as of November 7, 2014.
Managed Care Complaints
Although we like to think everything will go smoothly as LTC services are provided to more individuals with a managed care plan, we know there can be bumps in the road. Should a problem arise, the first step should be to contact the plan directly at their provider relations or provider ombudsman number. We will be listing contact information on this website soon for each plan.
If the issue is not readily resolved by the plan or keeps reoccurring, we want to know about it. Not just any problem, but one that the plan is not resolving or keeps happening over and over again. This can include delays in getting prior authorizations for hospital admissions, repeated claim denials, or early discharges from the SNF with negative consequences to the consumer. By letting us know, we can monitor the plans' behaviors and look for trends in the data. And we may be able to help find a resolution to your problem if you would like us to do so. So please fill out the provider unresolved complaint form, send us an email, or giving us a call at 614/461-1922.