The Academy of Senior
Health Sciences, Inc.
17 South High Street, Suite 770
Columbus, OH 43215
614.461.1922
800.999.6264
Fax: 614.461.7168
cmurray@seniorhealthsciences.org


The Academy of Senior Health Sciences, Inc: Managed Care

Information and Resources on Managed Care for LTC Providers

MyCare Ohio Rules

Enrollment Update
  • MyCare Timeline
    Updated enrollment timeline, including map of the different regions

MyCare Ohio Plan Resources

BuckeyeCaresourceUnitedHealthcareAetnaMolina
 
MyCare WebsiteBuckeyeCareSourceUnitedHealthcareAetnaMolina
Provider ManualProvider ManualProvider ManualProvider ManualProvider Manual Provider Manual

LTSS Provider Manual

Training MaterialsTraining SlidesClaims TrainingTraining SlidesProvider Training Nursing Facility Orientation Presentation
Key ContactsSee pages 2 and 3 of provider manual

Provider Relations

UHC key contactsImportant Phone Numbers

Provider
Relations by County

Reference GuidesBuckeye Quick Reference GuideCareSource Quick Reference Guide
Additional ResourcesFact SheetTransportation GuideMyCare Billing CodesFact SheetWebConnect Enrollment Process

SNF FAQs

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

Providers:

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.

Unresolved MCP Complaints – Providers