Medicaid Prior-Authorization

Submissions for Ohio Nursing Homes


    Service Overview

    ProviderGateway-LTC™ is a comprehensive online service that enables Nursing Homes to submit prior authorization requests and associated documentation to the Medicaid Authority in the State of Ohio. Other agents such as Managed Care and qualified Long Term Services agencies are also supported in this service.

    All transaction histories and audit trails are maintained to facilitate bi-directional communication while improving reimbursement cycle times and post payment audits. The service is fully web based requiring only access from a browser and no new software or hardware purchases

About ProviderGateway-LTC™

Provider Gateway-LTC™ works as a virtual messenger that tracks and supports transactions for client/patient access to Medicaid subsidized services in the network of Nursing Homes. Our system manages the accurate processing of prior-authorization transactions and related communications while ensuring that the order and content of submitted transaction in the Admit-to- Discharge cycle is complaint with audit standards enforced by Medicaid.

The transactions supported by ProviderGateway-LTC™ include New Admissions, Changes in Patient Liability, Changes in Patient Information, Patient Transfers (inter-facility) and Discharges. The system supports the review and approval process by caseworkers, via a secure portal as well as transmissions of secure documents to prequalified systems at the Medicaid offices.

Providers are secure knowing that all individual 9401 transactions are archived and stored securely. No third-party affiliations or other unauthorized nursing facilities have access to these documents, and Providers or Caseworkers can review previous submissions going back as far as three, five or even ten years. As a multi-tenant solution with a common base of patients, a comprehensive picture of patient movement between participating providers is maintained for audit resolution purposes, a further benefit to providers, clients and the Medicaid authority.