Two important process changes are coming related to Direct Billing and Level of Care.  ODM and DODD are providing training opportunities on each topic that you will want to attend.

Level of Care Application

Effective July 1, 2015, all Intermediate Care Facilities (ICFs) must use DODD’s online Level of Care (LOC) application system to complete a LOC for any person seeking ICF admission. The “Evaluators” of Level of Care have required training that must be completed prior to July 1st.  The training includes two online courses available on DODD’s website. The department indicated the courses should take no longer than a few hours and include a certification test.

A side reminder: Providers must use DODD’s Level of Care online tool for any ICF admission or roster changes beginning on July 1st. Prior to July 1, 2015 providers must continue to use the current IAF system for any roster changes.

It is important to make sure that the Level of Care “Evaluators” at your Home complete the required sessions and certifications.

For more details please see the Level of Care website.

Direct Billing-Things you should know…..

  •   Intermediate Care Facilities must use DODD’s online Level of Care Tool beginning with  July 1, 2015 dates of service.
  • Requires ICF-IID providers to directly submit claims to MITS for payment
  • MITS system will no longer automatically generate ICF per diem claims
  • CRIS-E system will interface with eligibility
  • DODD will approve Level of Care (LOC)
    • Counties will continue approving eligibility
  • Three Methods to Direct Billing Claims:
    • Log into MITS portal directly using current MCD provider number and enter data claims
    • Contract with a Trading Partner (TP)
    • Providers can become Authorized  TP
    • Provider Hotline:  1.800.686.1516

Onsite training is available in Columbus on July 15th or July 23rd from 9:00 a.m. to 3:30 p.m. The July 23rd session is also available as a Webinar if traveling to Columbus is not possible.

The department has directed Providers to register by  with your training date preference, provider name and number as well as the name of each attendee. Seating is limited for on-site training and offered on a first come-first served basis. Please note, registration will cut off two weeks prior to the session.  Visit the Ohio Department of Medicaid’s website for more information about the classes.

Direct billing for ICFs is effective July 1st, meaning the bills that are generated in August for dates of service of July 1st and later must go through the direct billing system in order to receive payment.  Please make sure all staff involved in billing participate in a training session whether onsite or a webinar.  DODD has assured the stakeholder community if system errors should arise, a contingency plan will be in place to ensure providers are paid.