April 2024
Provider Services 1-833-644-6001 

Change Healthcare System Interruption 

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:

  1. Claims payments: We have resumed payments for claims submitted prior to the incident. Since Change Healthcare is still unable to accept claims submissions, providers who submitted claims during the outage may be able to resubmit them either through additional solutions once they are available or once Change Healthcare’s connectivity is restored, through Change Healthcare. We appreciate the inconvenience this is causing providers and are exploring other options for the submission of claims.
  2. Electronic remittance advice: Electronic remittance are available at this time. However, some individual remittance advices may not be available due to Change Healthcare’s security incident.
  3. Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  4. Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please sign up.

Please note, in the interim, our Provider Services Department will not be able to assist with processing of your payments any sooner. If you have other questions, you may contact Provider Services at 1-833-644-6001.


We thank you for your partnership and will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.

We are seeking providers to serve in advisory roles 

AmeriHealth Caritas Ohio (ACOH) is seeking providers to serve in advisory roles to shape the Next Generation of managed care in Ohio. Partnering physicians will provide oversight and advise on policies and programs to help patients achieve better health outcomes and reduce the administrative burden for healthcare practitioners. Compensation provided for each meeting participation. Interested in advising? Please contact Bill Walters at wwalters@AmeriHealthCaritasOH.com.


Quality Assessment and Performance Improvement Committee (QAPIC)

  • Purpose: Oversight of ACOH efforts to measure, manage and improve quality of care and services delivered to members/patients.
  • Meetings: Monthly, every 3rd Friday, 7-9 a.m. (subject to change based on provider preference). Meetings are virtual except for one in-person meeting annually.
  • Materials: Delivered electronically one week prior to meeting.
  • Role of external physician: participate in the Quality Improvement (QI) program through planning, design, and implementation/review of the QI program, committee/subcommittees, policy decisions, performance, etc.
  • Ideal candidates: Practitioners with an interest in helping to improve the lives of Medicaid members. Specialty/background in primary care (FM or IM), maternal and infant health (OB/GYN), or behavioral health (MD, DO, PhD).
  • Financial Compensation: $250 per meeting occurrence.

    Provider Advisory Council

    • Purpose: Input into design and improvement efforts for plan programming impacting members and providers. The council will also advise ACOH on clinical improvement efforts, determine options to reduce administrative burden, identify systematic challenges and barriers, problem-solve, share information, and collectively find ways to improve and strengthen the healthcare service delivery system.
    • Meetings: Meetings will occur four times per year, generally in the last week of each quarter. 
    • Materials: Delivered electronically before each meeting with pre-read material usually no longer than five pages.
    • Role of external physician: Provide input and feedback into design of programs and performance improvement efforts.
    • Ideal candidates: Specialty/background in primary care, medical/surgical specialty, or behavioral health provider (MD, DO, PhD) with interest in learning how managed care plans develop clinical quality improvement, reduction in provider administrative burden, healthy disparity reduction efforts.
    • Financial Compensation: $250 per meeting occurrence.
        Ohio Department of Medicaid updates

      Reimbursement Information

      In 2023 ODM collected responses from all the MCEs regarding the claims and prior authorization denials processes. To streamline this for providers, ODM created two grids, one for claims denials and one for PA denials. The intent of both grids is for providers to have tools that explain the MCE claims and PA denials processes within one location. Both grids are located here: Reimbursement Information.

      Medicaid Agreement Revalidations
      IMPORTANT UPDATE: Terminations resumed effective January 23, 2024, for failure to complete Medicaid Agreement Revalidations in the Provider Network Management module.
      If you receive a revalidation notice, it is imperative that you take immediate action to complete and submit your revalidation application to renew your Ohio Medicaid Provider Agreement. On January 23, Ohio Department of Medicaid started terminating providers who fail to complete their revalidation prior to their specified deadline. To complete revalidation, please visit PNM & Centralized Credentialing.

      The importance of the SL modifier in childhood vaccines

      Vaccines for Children (VFC) Program

      AmeriHealth Caritas Ohio primary care physicians (PCP) are required to enroll with the Ohio Department of Health (ODH) Immunization Program to receive vaccines for members under age 19 years through the Vaccines for Children Program. Vaccinations covered by the VFC program will not be reimbursed by AmeriHealth Caritas Ohio; however, the Plan reimburses providers for appropriate vaccine administration to members aged 18 years and younger. Providers are expected to plan for a sufficient supply of vaccines and are required to report the use of VFC vaccines immunizations by:

      • Use the “SL” modifier to indicate the provider is participating in the program
      • The SL modifier must be listed on the vaccine line of the claim and will result in no reimbursement.
      • Providers will receive reimbursement for the administration of the vaccine only
        Updated rates
        The new rates are available on ODM's website.
        Review and update your Specialties page in the Provider Network Management module when completing revalidation or reapplication
        ODM has seen an increase of provider specialty discrepancies, especially among the Physician/Osteopath Individual provider type. Because of this, providers are strongly encouraged to review the provider specialty page in the Provider Network Management (PNM) module for accuracy.

        What action do providers need to take?
        Review the PNM Specialties page during your revalidation/reenrollment process to make any updates or adjustments to the active practicing specialties. Please note, the “200 Physician/Osteopath Individual” specialty type is no longer a valid specialty and would require an update to add the correct specialty in PNM. See the Specialty Quick Reference Guide for instructions.
        Updated HEDIS Guidelines for the Care Gap Closure program
        Click here to view the HEDIS 2023 Documentation and Coding Guidelines for care delivered in 2024.
        Ohio Department of Medicaid fraud warning
        Criminals are targeting Medicaid recipients for sensitive, personal, and financial information. If your patient gets a call, text, or email about Medicaid benefits asking for a Social Security number, payment, bank, debit, or credit card information, advise your patient to not respond. They’re not from the State of Ohio or any agency. Instead, it should be reported to the Ohio Attorney General at 1-800-282-0515 or click here to complete the online form.
        Incomplete PNM affiliation steps may impact provider billing
        Through a series of PNM queries, Ohio Department of Medicaid (ODM) has identified several affiliation issues that impact billing organizations claims. It is imperative that providers fully execute all steps when affiliating a rendering provider to their group/organization/hospital to avoid claims payment issues. An Affiliations Quick Reference Guide (QRG) has been created, showing step-by-step instructions and information related to entering an affiliation as a new individual practitioner; confirming, adding, and removing an individual practitioner’s affiliation as a group or organization. 
        New administrator change form
        ODM developed a new form, ODM10304, that must accompany requests to change Provider Network Management (PNM) Administrators from one billing organization provider to another. As a security measure, you must submit a formal request to transfer Administrator ownership of a Medicaid ID within the PNM module. More details are available on ODM's website.  
        Claim submission and adjudication FAQ 
        ODM updated the Claims and Prior Authorization Submission Frequently Asked Questions (FAQ) to make it easier for you to find the information you need. It covers fee-for-service, managed care, and OhioRISE billing procedures, adjudication processes, and other answers to common provider questions. You can review the FAQ on the submitting claims and prior authorizations page on the Next Generation website.

        EPSDT- HEALTHCHEK annual education as required by ODM

        The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit provides comprehensive and preventative health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventative, dental, mental health, developmental, AND specialty services.

        Screenings Must Include:

        • Comprehensive Health and Developmental History
        • Comprehensive Unclothed Physical Exam
        • Laboratory Tests – Including Lead Toxicity Screening as guided by the child’s age
        • Appropriate and needed immunizations
        • Health Education – Anticipatory Guidance including Child Development, Healthy Lifestyles, and Accident and Disease Prevention
        • Vision Services – at minimum, diagnosis and treatment for defects in vision, including eyeglasses
        • Dental Services – at minimum, relief of pain and infections, restoration of teeth, and maintenance of dental health
        • Hearing Services – at minimum, diagnosis and treatment for defects in hearing, including hearing aids
        • Nutrition assessment and education
        • Other Necessary Health Care Services – diagnostic and treatment services must be provided when a screening examination indicates the need for further evaluation

        Important Links and Information

        Email links

         Resources and reminders

        Need help?

        Reminder to providers regarding overpayments

        AmeriHealth's Claims Cost Containment Unit is responsible for the manual review of overpaid claims submitted by the Program Integrity department for potential recovery. Claims submitted to the Claims Cost Containment Unit for review are outside of the Subrogation and Check Reconciliation areas. Some examples of identified “waste” include:

        • Incorrect billing from providers causing overpayment.
        • Overpayment due to incorrect set-up or update of contract/fee schedules in the system
        • Overpayments due to claims paid based upon conflicting authorizations or duplicate payments.
        • Overpayments resulting from incorrect revenue/ procedure codes, retro TPL/Eligibility.

        The Claims Cost Containment Unit is also responsible for the manual review of provider-initiated overpayments. Providers who self-identify claim overpayments may submit their inquiries for review to:

        AmeriHealth Caritas Ohio

        Attn: Claims Cost Containment

        PO Box 7320

        London, KY 40742


        Further information can be found on pages 115 through 117 of the ACOH Provider Manual.


        Reminder to providers regarding urine drug screening
        Drug screen testing detects the presence of drugs or drug classes in a patient’s system during an encounter. The results are reported as positive or negative for the presence of a drug or drugs but do not indicate specific levels. The tests provide information about recent drug use but do not distinguish between occasional users and those who are dependent on or otherwise impaired by drug use. 

        Drug screen testing includes: 

        • Presumptive drug class screening used to identify possible use or non-use of a drug or drug class. It is done on a random basis or for cause, the latter of which should be documented in the medical record. In substance use disorder treatment settings, presumptive testing should be a routine part of initial and ongoing patient assessment. 
        • Definitive drug class screening comprised of qualitative (drug is present or absent), semi-quantitative, or quantitative (measured) tests to identify possible use or non-use of a specific drug; typically, therapeutic drug assay procedures are quantitative tests. Definitive testing may be used to detect specific substances not identified by presumptive methods and to refine the accuracy of the test results when the results are needed to inform clinical decisions. 
        Drug testing should supplement information obtained by history and physical examination and should never be the sole basis for making a diagnosis of a substance use disorder (American Society of Addiction Medicine, 2019). Drug testing should be performed for individuals who would be helped most by such screens. Routine drug screening in the absence of clear clinical suspicion for illicit use should be avoided. Choice of test matrix, selection, and frequency should fit the needs of the tested population, with more intense and less predictable testing reserved for persons at highest risk of drug use (American Society of Addiction Medicine 2019, Manchikanti, 2012). 

        AmeriHealth follows OAC rules associated with presumptive and definitive drug screens.

        • For presumptive screens, thirty dates of service per benefit year; and
        • For definitive tests, twelve dates of service per benefit year.

        PNM portal

        Until it is fully active, please continue to send roster updates to both PNM and the MCO’s. Behavioral Health providers ARE able to only update through the PNM portal without submitting rosters to the MCO’s.

        Prior authorizations
        Submit authorizations electronically through NaviNet
        AmeriHealth Caritas Ohio offers our providers access to our Medical Authorizations portal for electronic authorization inquiries and submission. The portal is accessed through NaviNet and located on the Workflows menu.

        In addition to submitting and inquiring on existing authorizations, you will also be able to:
        • Verify if No Authorization is Required
        • Receive Auto Approvals, in some circumstances
        • Submit Amended Authorization
        • Attach supplemental documentation
        • Sign up for in-app status change notifications directly from the health plan
        • Access a multi-payer Authorization log
        • Submit inpatient concurrent reviews online if you have Health Information Exchange (HIE) capabilities (fax is no longer required)
        • Review inpatient admission notifications and provide supporting clinical documentation
        Prior authorization lookup tool
        To find out if a service needs prior authorization, click here to get started. 
        • Wait for the page to fully load
        • Enter a CPT or HCPCS code in the search box at the bottom of the page
        • Click Submit
        • The tool will tell you if that service needs prior authorization
        Medicaid Annual Eligibility Redetermination Reviews
        Information for providers regarding Annual Eligibility Redetermination Reviews is on our website. This federally required process is in place to ensure those enrolled in Medicaid programs continue to meet established eligibility criteria. AmeriHealth Caritas Ohio will collaborate with Ohio Department of Medicaid and our provider network to minimize the burden on our members and promote continuity of health coverage.
        Access and Availability Standards
        As part of ongoing network management, periodic outreach to confirm maintenance of access and availability standards does occur. The specific access time frames are determined by the provider type of the service and is outlined starting on page 34 of the AmeriHealth Caritas Ohio Provider Manual.  
          Claims and billing

        Consent Forms

        Providers must submit the appropriate required forms (ODM 03197, ODM 03199, HHS-687, and HHS687-1 [SPANISH VERSION]) with the claim’s submission for these services. Appropriate consent forms can be found on AmeriHealth Caritas Ohio's website or on the ODM website at Pregnancy Risk Assessment | Medicaid (ohio.gov). Providers can submit the consent form along with their claim through Change Healthcare:

        • Submit a 275 claim attachment transaction. AmeriHealth Caritas Ohio is accepting ANSI 5010 ASC X12 275 unsolicited attachments via Change Healthcare. Please contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic 275 attachment submissions via payer ID 35374.
        There are three ways that 275 attachments can be submitted:
        • Batch - you may either connect to Change Healthcare directly or submit via your EDI clearinghouse.
        • API via JSON - you may submit an attachment for a single claim.
        • Portal - individual providers can register at Change Healthcare to submit attachments.
        The acceptable supported formats are pdf, tif, tiff, jpeg, jpg, png, docx, rtf, xml, doc, and txt. View the Change Healthcare 275 claims attachment transaction video for detailed instructions on this process. In addition, the following 275 claims attachment report codes have been added. When submitting an attachment, use the applicable code in field number 19 of the CMS 1500 or field number 80 of the UB04, as documented in the Claims Filing Instructions (PDF).

        Attachment type

        Claim assignment attachment report code

        Itemized bill


        Medical records for HAC review


        Single case agreement (SCA)/LOA


        Advance beneficiary notice (ABN)


        Consent form


        Manufacturer suggested retail price/invoice


        Electric breast pump request form


        CME checklist consent forms (child medical eval)


        EOBs — for 275 attachments, should only be used for non-covered or exhausted benefit letter


        Certification of the Decision to Terminate Pregnancy


        Ambulance trip notes/run sheet


        Do not send paper claims
        The Next Generation of Ohio Medicaid program's guidelines require all claims to be submitted via the Electronic Data Exchange (EDI). If you have submitted a paper claim, you will be advised that your claim has not been processed and what your next steps should be. You can get started on our website with claims how-tos, quick guides, links and contact info.  

        Correcting Claims

        Oops! What if I submitted claims with the wrong rate or CPT code? Please refer to our Provider Claims and Billing Manual on how to submit corrected claims on page 52.

        Provider Claims and Billing Manual - Box 33, no PO Box allowed
        Field: 33
        Field description: Billing provider Info and phone number
        Required - identifies the provider that is requesting to be paid for the services rendered and should always be completed. Enter the physical location; PO Boxes are not acceptable. 
        • Required fields must be completed on all claim
        • Loop ID: 2010AA
        • Segment: NM103, NM104, NM105, NM107, N301, N401, N402, N403, PER04.
        See page 17 of the Provider Claims and Billing Manual.  

        Claims Payment Systemic Error (CPSE) report

        The Claims Payment Systemic Errors (CPSE) report is updated and posted on the ‘Alerts and Newsletter’ page monthly. AmeriHealth Caritas Ohio encourages you to review this log frequently and before contacting our Provider Services team. If you have additional questions, please feel free to reach out to Provider Services at 1-833-644-6001 and, as always, you can reach out to your local account executive.

        When should the provider submit an Appeal vs. Dispute?

        Item and Definitions


        Contact Information


        Filed by the member or provider on behalf of the member (with a waiver), related to a denied Service/IP service (Prior Auth denials, Limit to service/Auth) when there is no claim on file.

        60 days from the date of denial letter sent by UM.

        Medical appeals must be submitted in writing to:

        Claim Processing Department

        AmeriHealth Caritas Ohio
        P.O. Box 7346
        London, KY 40742


        Provider asking for more information on a claim and how it was processed.


        If determined the claim can be adjusted, then the inquiry is a dispute and should follow that timeframe.

        NaviNet portal (www.navinet.net)

        Dispute (or Provider Claim Appeal)

        Provider disagreeing with the way a claim was processed, paid, or denied.

        ODM outlines the following categories of items that are considered a dispute:

        • Claim Status
        • Eligibility
        • Other insurance
        • Improper claim submission 
        • Overpaid/underpaid
        • Provider not eligible to provide service
        • Payment amount clarification
        • Provider not credentialed
        • Duplicate claim
        • Timely filing 
        • Documentation issues 
        • Recoupments
        • Prior Authorization
        • Medical Necessity 
        • Level of Care (LOC)
        • Non-covered services
        • Provider affiliation 
        • Payment not received 
        • Patient Liability
        • Sterilization/Hysterectomy consent form 
        • Past Dispute Timeframe 

          12 months from the DOS or 60 days from the EOB date.

          Written disputes should be mailed to:

          Claims Disputes

          AmeriHealth Caritas Ohio
          P.O. Box 7126
          London, KY 40742




          Access the Provider Dispute Submission Form (PDF)

          Billing for Hospital Readmission

          For prompt and accurate payment processing, please consult ODM's Hospital Guidance on Hospital Readmissions found on page 31 of the Hospital Billing Guidelines.


          Please note, that ODM instructs the following concerning readmissions to a hospital:
          • If a recipient is an inpatient in a hospital, is discharged, then subsequently re-admitted to the same hospital within a day, the hospital must collapse the two inpatient stays into one admit through discharge claim. The hospital must report one non-covered day at the header and use Revenue Code 180 to report a non-covered day at the detail.
          • For example, if the recipient is hospitalized 1/1 and is discharged to a NF on 1/5, then re-admitted to the hospital on 1/6, the hospital must report one non-covered day for the first date of discharge (1/5) at the header, and one non-covered day at the detail level, RCC 180.
          Depending on which claim (hospital or NF) is paid first, the second claim will deny as a duplicate due to a systems configuration limitation that will not process two claims with overlapping dates of service (i.e., the day the patient is readmitted to the NF for 8 hours or more). As a workaround, if your claim is denied as a duplicate, please resubmit your claim via the 6653 process for manual review.

          Diabetes Self-Management Education Enhanced Reimbursement Rates 

          AmeriHealth Caritas Ohio and the Ohio Managed Care Organizations (MCOs) are working collaboratively to make diabetes management easier for providers and their patients. Diabetes education and support for the use of continuous glucose monitors (CGMs) have proven to be effective in diabetes care management.
          To facilitate increased utilization of these enhanced tools, AmeriHealth Caritas Ohio and the other MCOs will pay an enhanced rate to providers rendering Diabetes Self-Management Education (DSME) and billing the appropriate codes: G0108 and G0109. In addition, PA is not required for members who receive a covered CGM device through durable medical equipment (DME) providers or through their pharmacy. Providers must use HCPCS codes A4239 and E2103 for CGMs provided through DME.


          Services rendered in 2023 should be submitted without delay to prevent denials.
          For additional information regarding these updates, including who to contact at each MCO for questions, see the quick reference guide on our provider website.

          Pain Self-Management Education (PSME) is in full swing!  

          PSME is a four-session educational program for adults living with chronic non-cancer pain. PSME teaches pain self-management, healthy lifestyle, mindfulness, and healthy coping skills, with the goal of empowering people to live full and productive lives with pain.


          This program is offered in collaboration with Meridian HealthCare at no cost to adults 18+ living with chronic pain and insured by ANY Ohio Medicaid plan.


          To refer to this program, please direct patients to contact Meridian HealthCare directly at 1-330-797-0070 or email chronicpain@meridianhealthcare.net. Additional program information and referral flyers can be obtained by contacting Jhilleary@AmeriHealthCaritasOH.com.

          Mobile Wellness, meeting communities right where they are
          Our Mobile Wellness and Opportunity Center can come to your community! Depending on availability and established criteria, you can work with AmeriHealth Caritas Ohio to
          conduct classes, wellness events, or health education within and around the bus.

          The mobile unit is equipped with kiosks where attendees can access computers and a private location where providers can perform health screenings and engage personally with members.

          Working with AmeriHealth Caritas Ohio, you can increase accessibility to services that address the social determinants of life and improve conditions for members of the community. We are pleased to offer this convenience at no cost to you and your community.
          For more information or to reserve time with the Mobile Wellness and Opportunity Center, click to complete the request form or email us at Comms@AmeriHealthCaritasOH.com. We welcome the chance to work with you to help people get care, stay well, and build healthy communities.

          Tell us a little bit about where you’re from.  I was born in New Castle, IN and I grew up in the small town of Brookville, Ohio where I attended Brookville High School. My Mom and Dad are still in Brookville and I have a younger sister who lives in Chicago. I graduated from Heidelberg College with a degree in Public Relations and a minor in Communications. 


          Everyone at AmeriHealth Caritas Ohio (ACOH) has a story about why they joined the team. What’s yours?  I had worked for another health plan for years prior to joining AmeriHealth. I was intrigued when they were chosen as one of the new plans as part of the Next Generation model and did some research. I was very impressed with the history, goals and mission of the company. I had worked with Mark Grippi previously and had some great conversations with him about what he wanted to create here in Ohio. I knew that I wanted and needed to be part of that vision! It’s hard to believe it’s been over two years. I love working here and especially love my team and co-workers! 


          What drew you to this profession?

          I had worked for many years in customer service and training. I was always intrigued by the health care industry and found a perfect time and opportunity to change fields. I was able to take my years of relationship building and service skills and translate them to the world of managed care. I love people and this is a great way to serve our members and provider partners with that passion!

          What do you like to do in your free time? In my spare time, I really love to travel and be with family and friends. You will find me on the golf course most weekends if the weather is nice and sipping a nice bourbon when the opportunity arises! Fun fact: I love soap operas and am still current on a few. 


          If you could have dinner with anyone in the world, dead or alive, who would it be? Why? I think I would probably break bread with “The Chairman of the Board”, “Old Blue Eyes”, Mr. Frank Sinatra. I would just love to hear all of his stories of the music and film industry. Discuss all of his travel, life experiences, and being an early activist in the civil rights movement. He was a one of a kind talent and I have always been a big fan.  


          What are two apps on your phone you CANNOT live without? WAZE is a must-have for all of the driving that I do. It has saved me countless hours by going around major traffic issues. I also love Instagram and can easily go down the rabbit hole of reels, howling with laughter.


          Any interesting facts about yourself that you’d like to share? This year marks 28 years of marriage for me and my wife Annissa. We have two daughters. Hannah, who lives in Toledo and works as a nanny and Lilly, who is currently in her third year at The University of Cincinnati in the DAAP (College of Design, Architecture, Art and Planning) studying fashion design. We couldn’t be prouder of both of them! 

          My contact info:
          Bill Walters, Director, Provider Services
          Click here to find your Account Executive.
            Upcoming webinars

          New CEU opportunity from AmeriHealth Caritas Ohio!

          On April 25, our Market Health Equity Program Director, Patricia Lyons Ph.D., LISW-S will present a virtual workshop. Cultural and Intercultural Competence: Opportunities and Recommendations for Behavioral Health Professionals has been approved for two free CEUs for Ohio Counselors, Social Workers, and Marriage and Family Therapists. Click here for more details and to register

          Provider orientation with ACOH 

          We encourage providers to attend one of our new provider orientations. This ODM-required presentation offers us the opportunity to introduce ourselves to our new providers. These presentations include information on our unique member benefits, value-based care program, claims and billing information and our provider portal, NaviNet. Join your personal account executives online on these dates or contact your local Account Executive to schedule an individual orientation. Click here to see the entire calendar and register.

          Have you completed a new provider orientation?   
          Don't forget to complete the attestation if you have already attended a session. Click here to get started.
          Cultural Competency Training
          AmeriHealth Caritas Ohio is committed to promoting education on and awareness of culturally and linguistically appropriate services (CLAS) and to combatting the effects of low health literacy on the health status of our members. There are several training opportunities on our website

          2024 Comprehensive Primary Care (CPC) Webinar Series with ODM

          ODM will virtually share program updates, resources, best practices, and more. They are scheduled on:

          • Thursday, April 18
          • Thursday, September 19
          • Thursday, November 14
          Click here to register

          Ask a Sandata trainer

          Do you have questions about Electronic Visit Verifications (EVV)? You can schedule a private Zoom session with a Sandata trainer to discuss your EVV questions. The sessions cover: improving claims matching, solving reoccurring exceptions, and getting started with EVV.

          Black Maternal Health Week  

          April is host to several conditions that aim to bring awareness in the healthcare space. Some of those are, Sexually Transmitted Diseases month, Sexual Assault Awareness, Women’s Eye Health and National Infertility Awareness Month. All of which are important causes and deserving of our attention. There is one other however, one stands out and really hits deep in Ohio as healthcare providers work to improve health outcomes and that is Black Maternal Health Week (April 11-17). 


          Each year in the United States hundreds of women die during pregnancy or within the first year after delivery. Thousands more experience both short- and long-term health problems due to unexpected outcomes from labor and delivery. 80% of pregnancy related deaths are preventable. The Ohio Department of Health recently documented that the maternal mortality rate is 14.9/100,000, which is 29.5%. Black women are 2.5 times more likely than white, non-Hispanic women to die from a pregnancy related issue than white women in Ohio. Hypertension was cited as one of the most preventable causes of maternal death.


          As healthcare providers you can help by:

          • Ask questions to understand more about the stressors patients experience.
          • Help patients manage chronic underlying conditions.
          • Review-re-review urgent warning signs and when to seek care immediately.
          • Recognize and work to mitigate unconscious bias in the area you work.
          • Respond to patient concerns.
          • Provide respectful quality care.
          • Gather information on previous pregnancies.
          • Identify social factors affecting your patients such as unstable housing, lack of food or transportation, substance use, violence, racial inequalities.
          • Listen to your patient - this can be one of your most important tools.
          • Learn more about the Hear Her Campaign supported by the CDC.
          • Access training on Culturally and Linguistically appropriate services (CLAS) in maternal healthcare (CE’s available)
            April is Foot Awareness Month
            Diabetes is a growing concern for many and with that comes many issues. With unmanaged blood sugars comes potential for foot issues, such as neuropathy, decrease circulation and foot ulcers. Reminding our members that not only do they need to check their blood sugars, but they should also be checking their feet, including in between their toes, to find foot problems early and prevent complications. If they are unable to check their feet it is helpful if they have someone that lives with them or possibly a friend or family member complete that task for them.

            Key messages to share with our members:

            • Encourage your patients to ask for a basic foot check at every health care visit
            • Tell your patients that:
              • Diabetes-related complications can start in their feet and may not cause recognizable symptoms.
              • A basic foot check at every health care visit, combined with annual comprehensive foot exams, can help identify problems early
              • Patients with poorly managed blood sugar or high blood pressure may benefit from having their feet checked more often, such as every 3 or 6 months.
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