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Ohio Medicaid Extends Timely Filing Deadline Until 2025

Client Alert
December 11, 2024

The Ohio Department of Medicaid (ODM) recently announced that it is extending its timely filing deadline to February 28, 2025. According to ODM, roughly 2% of providers have contract issues preventing them from meeting the previous timely filing deadline of December 1, 2024.

Before March 1, 2025, providers need to:

  • Submit as many claims as they can now to avoid additional manual work and time required to process them after the deadline. If a data fix or system configuration is required to properly adjudicate the claim, ODM will adjust claims successfully received by the system even if the timely filing deadline has passed.
  • Review Provider Network Management (PNM) data associated with claims denied for a contract or affiliation related issue to make sure it is correct. If the PNM data is correct, but a provider received a denial indicating a contract or an affiliation issue, report these issues to ODM’s Integrated Helpdesk (IHD).

Note that even though ODM extended the timely filing requirements, claims submitted after the standard 365-day limit are still subject to post-payment review. ODM may look at evidence of system submissions issues when deciding whether to reverse payment. Evidence may include review of past IHD call logs to verify that providers attempted to troubleshoot their issue.

Providers are encouraged to reach out to the ODM IHD with questions.

If you have questions about the extended deadline and what that means for your organization, please contact Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.

Health LawHealthcareOhio Department of Medicaid
Client Alert

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September 4, 2024Ohio House Bill 68, effective August 6, 2024, introduces strict guidelines for mental health professionals diagnosing and treating minors with gender-related conditions. The law mandates parental or guardian consent before any diagnosis or treatment can proceed. Additionally, professionals must first screen for other comorbidities and assess for any history of abuse. Failure to adhere to these requirements can result in disciplinary action for unprofessional conduct.Client Alert, Multimedia

Navigate the Latest Employment Law Changes with Confidence

August 13, 2024BMD Partner and Co-Chair of the Employment & Labor Law Group, Bryan Meek, presented this webinar on trending HR topics. Topics include the new Fair Labor Standards Act changes for exempt employees and Federal Trade Commission's nationwide ban on non-competes. Discover how these groundbreaking changes will impact organizations nationwide and what they need to do to ensure compliance.Client Alert

Planning for Wealth: Lessons from Athletes, Entertainers, and Executives

August 1, 2024The financial challenges and strategies used by high-income earners like Donovan Mitchell, Taylor Swift, and Jamie Dimon are not just for the wealthy—they can apply to anyone managing significant assets. This article delves into essential wealth management techniques, from leveraging tax exemptions to navigating major liquidity events, providing valuable insights to help you achieve financial stability and preserve your wealth.Client Alert

The Ohio Department of Medicaid Amends Fraud, Waste, and Abuse Rules

July 29, 2024Ohio Department of Medicaid has updated definitions of fraud, waste, and abuse as well as given specificity and clarity to the list of examples.Client Alert

Ohio Department of Medicaid Proposes Changes to Dental Reimbursement and Coverage Rule

July 29, 2024The Ohio Department of Medicaid is proposing amendments to Ohio Administrative Code. There will be a hearing on the proposed rule changes August 12, 2024.
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