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Paper behavioral health claim disputes.

Submit through ODM OMES (fiscal intermediary) using Payer ID 0004202 (Buckeye Ohio Medicaid, 837P/I), V004202 (Envolve Vision) or D004202 (Envolve Dental), or individually via Secure Provider Portal/Availity. Buckeye no longer accepts paper Medicaid claims effective January 1, 2026, and does not accept 837 batches directly.

Inpatient continued-stay clinicals, discharges, and retrospective review requests (note retro review on cover sheet).

Paper medical claim disputes; portal submission is also available. Include servicing provider, member name/ID, DOB, DOS and claim number.

Pre-service provider appeals of PA denials (ORC 5160.34) and expedited appeals: portal, fax, phone or mail, within 60 days of the Notice of Adverse Action. Post-service medical necessity disputes go through the claim dispute process.

Buckeye Ohio Medicaid provider services (claims, eligibility, interpreter/transportation help, FWA reports). Have NPI, TIN and member ID ready.

Standard PA is portal/Availity only. Fax is for Medicaid urgent PA requests and SNF, LTAC and rehab continued-stay clinicals and discharges. Prior authorization phone 866-246-4359 is already listed on the Buckeye prior authorization line.

Provider services for Wellcare by Buckeye Health Plan, Next Generation MyCare Ohio program.

Written PCP requests to remove a member from a panel, with documentation, to Buckeye Member Services.

Provider services for Wellcare (Medicare) plans offered through Buckeye Health Plan in Ohio.

Carolina Complete Health (Centene) NC Medicaid Managed Care provider services: eligibility IVR, claims, authorization requests and general questions. The former WellCare of North Carolina provider contact page (wellcarenc.com) now redirects to the Carolina Complete Health network site. Fax shown is the provider services fax from the 2026 provider manual key-contacts table.

Member (beneficiary) appeals and grievances by mail, per the provider manual key-contacts table; general grievances and appeals phone is provider services. Provider claim disputes go to PO Box 8040 instead.

Concurrent review clinical records for inpatient stays.

Initial inpatient authorization requests and face sheets.

Inpatient behavioral health PA requests.

Medical records submitted for utilization management review; not a release-of-information line.

Outpatient behavioral health PA requests.

Paper claims and encounters (billing manual) and medical claim provider disputes/appeals (provider manual key contacts) all go to PO Box 8040. Electronic payer ID 68069 (Availity, Change Healthcare, Ability); EDI questions go to the Centene EDI department (1-800-225-2573 ext. 25525, EDIBA@centene.com). Refund checks use separate Dallas, TX lockboxes listed on the Claims and Billing page.

Off-label requests for physician-administered drugs.

Outpatient prior authorization requests (Standard Plan fax reference guide).

HCA PDF "MCO customer service number" column.

Behavioral health fax printed on both the outpatient and inpatient Apple Health PA forms.

Email the Contracting Department with provider information and signed W-9 to join; review typically takes 15–20 business days. Existing providers update data through the Provider Update Tools page.

Statewide provider engagement mailbox for Indian Health Care Providers (IHCP).

Fax completed inpatient prior authorization/referral form for medical admissions.

Fax completed Apple Health outpatient PA form for medical services. Behavioral health uses 833-286-1086; transplant uses 833-552-0998.

Coordinated Care handles non-participating outpatient therapy authorizations and benefits at this number, ext 69617; other therapy/imaging concerns go to Evolent/NIA (RadMD).

Apple Health (Medicaid) paper claims: initial, resubmitted, corrected claims and COB go to Attn: Claims Department; claim disputes (Level II, after an unsatisfactory reconsideration) go to Attn: Claims Dispute at the same PO box. Electronic Payor ID 68069. Claim status questions: provider services 1-877-644-4613 (existing line).

Pharmacy claims help desk for Coordinated Care pharmacy benefits.

Pharmacy Services PA for Apple Health members; response by fax or phone within 24 hours. ePA via CoverMyMeds also accepted.

Transplant authorization requests.

TTY 711.

Behavioral health inpatient, partial hospitalization and residential requests (general Medicaid plan), per the provider toolkit; also listed on the inpatient PA form and behavioral health page.

Behavioral health paper claims. BH EDI payer ID 68068.

Direct line to Home State Health behavioral health/substance use utilization management and customer service staff, per the Medicaid pre-auth page.

Reconsiderations and claim appeals must be received within 180 calendar days of payment/denial notice. Not for medical necessity appeals. Use the Reconsideration and Appeal Request form.

Credentialing and provider data (rosters, practitioner adds/terms/changes) for contracted Home State groups.

Fax the Interpreter Services Request for in-person interpreters at provider offices (2-3 business days).

Fax number printed on the Home State Health Missouri Medicaid inpatient prior authorization form (MO-PAF-0710, 2025). Behavioral health inpatient goes to the BH fax instead.

Home State Health (Centene) Missouri Medicaid. Toolkit: secure provider portal is preferred; phone after hours/holidays routes to the 24-hour Nurse Advice Line. Medical PA fax per the Medicaid provider toolkit and outpatient PA form. Use the Pre-Auth Needed tool first. TTY: 711.

Timely filing 180 days from DOS or per contract. EDI payer ID 68069 (medical), 68068 (behavioral health). Portal or clearinghouse preferred.

Provider complaint form mail address (Complaint and Grievances Coordinator). Verbal complaints via Customer Service Advocates.

General provider questions for Home State Health Missouri (join/network page).

Show Me Healthy Kids (Missouri foster care Medicaid plan) residential, treatment foster care, aftercare and transitional TCF requests.

Show Me Healthy Kids (Missouri foster care/adoption Medicaid program run by Home State Health) customer service line listed in the Medicaid provider toolkit. TTY: 711.

Turning Point handles ENT and cardiac service authorizations for Home State Health Medicaid, per the pre-auth page. Imaging/MSK/therapy go to Evolent instead.