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Help – Ohio Medicaid SPBM Webpage Home Navigation Bar
Navigation Tabs
Home This is the public landing webpage for the Ohio Medicaid SPBM online portal. Registered users may sign into their Member or Trading Partner account, access forms and documents, and look up Ohio Medicaid Pharmacy Providers from this screen. Navigation Bar Contact Us The Contact Us window provides contact information such as office hours, email addresses, and phone numbers. Registered users may sign into their account to chat with an agent and access Grievance and Appeal information that may be submitted online or print forms for mailing. Pharmacy Directory To search for an enrolled Pharmacy Provider, select the Pharmacy Directory from the drop-down menu on the Ohio Medicaid SPBM Online banner. Reference Material The Reference Material window provides links to the Unified Preferred Drug List and clinical criteria, Billing Instructions, Companion Guides, User Guides, and Manuals. The Reference Material window also provides links to other publications such as newsletters and frequently asked questions for both Providers and Members. Navigation Tabs General This tab provides information to Ohio Medicaid Members, Providers, Trading Partners, and the Public such as Announcements, Medicaid News and a Pharmacy Directory. There are external links on this tab o Drug Recalls and Shortages, the Ohio Department of Medicaid Drug Utilization Review (DUR) Board and Pharmacy and Therapeutics (P&T) Committee, the Ohio Department of Medicaid website, and the Ohio Medicaid Managed Care Plans. Member This tab provides access to Member information which includes a link to the Ohio Medicaid SPBM Member handbook . A Member can sign into their account to access the secure online portal. Provider This tab provides access to Provider announcements, information, documents, and links of interest specifically for Providers and Trading Partners. The secure section of the Ohio Medicaid SPBM portal enables authorized, registered Trading Partners to submit pharmacy claims, prior authorization requests, check Member eligibility, and review claim payment status. Trading Partner Access Providers, Billing Agents, Clearinghouses, and Health Plans must register to access the Provider enrollment application. Pharmacies and prescribing Providers must be enrolled with Ohio Medicaid prior to registering as a Trading Partner. Trading Partner account registration/activation enables access to the secure Provider portal for direct data entry of claims and prior authorizations, Member eligibility inquiries, claim status inquiries, remittance advice, and more. Ohio Medicaid Members or personal representatives must register to access member- specific information such as prescription history and prior authorization status. Sign In Providers, Billing Agents, Clearinghouses, Health Plans, and Ohio Medicaid Members or Personal Representatives who have an existing account can sign in to access the secure functions of the portal and account information. User Name and Password Once a Provider, Billing Agent, Clearinghouse, Health Plan, or Member creates his or her Trading Partner Account (TPA), he or she will need to enter the TPA user name and password to access the secure section of the portal. Password Reset and Username Retrieval Providers, Billing Agents, Clearinghouses, Health Plans, or Ohio Medicaid Members and Personal Representatives can reset their password by correctly answering the security question that is entered during the registration process. An email is sent to the registered email account on file, providing a web link to reset the account password. A registered user can retrieve a forgotten username by correctly answering the security question that is entered during the registration process. The username is sent to the registered email account as listed during the registration process. |