Information for Providers

Obtaining Information from BCMH

BCMH staff members are available to assist providers by supplying information and technical assistance.  When contacting BCMH be prepared to provide the following information:

·         Your name

·         Your telephone number

·         Brief description of the question or problem, e.g., billing, insurance, authorization of services, provider enrollment status or financial review

·         Best time to return your call

For a specific child’s case*, the following information will be needed:

·         Child’s name

·         Child’s birth date

·         BCMH case number, if available (the case number is located on the Letter of Approval (LOA) and on all correspondence from BCMH related to the child)

·         Child’s county of residence

*Please note:  Confidentiality is carefully maintained.  BCMH cannot give out case information to anyone except a parent, guardian or the client if the client has reached 18 years of age.  Once a release and consent form is signed, information may be given to BCMH providers and public health nurses.

Available Staff/Resources in the Central Office

Claims Processing

These individuals are responsible for the processing of claims to the BCMH in a timely manner.  They are able to assist providers with proper coding of invoices.

Customer Service Assistants

These individuals answer the main switchboard telephone and take messages.  They can also assist with general questions regarding the status of a case and eligibility of medical diagnoses.

Nurse Case Managers

The nurse case manager (NCM) is a registered nurse who determines BCMH medical program eligibility and authorizes services.  The NCM applies standards of care and regulations and interprets and assesses medical plans of treatment.

Provider Management

The provider management staff is responsible for the credentialing of all providers who apply to become active providers on the BCMH program.  They answer questions regarding provider qualifications, changes in addresses and billing information and remove providers who no longer meet BCMH qualifications, relocate or request removal.  The BCMH list of approved providers is available on the Web at BCMH providers and click on the county where you are looking for a provider.

Resource Payment Specialists

Resource payment specialists determine the financial eligibility of children for the Treatment Program.  They make referrals and provide families with information for Ohio Department of Job and Family Services (ODJFS) Medicaid programs.

Third Party Resources

The staff in the Third Party Resources unit investigates sources of payment for medical services that may be available through Medicaid, private insurances and Medicare.  They are available to assist providers and families in coordinating third-party benefits.

Other Staff

Other available staff in the central office includes:  registered dietitian, pharmacist consultant and parent consultant.

Available Staff/Resources in the District Offices

Field Nurse Consultants

BCMH employs registered nurses who serve as local representatives for BCMH.  They are available to local agencies that serve children who reside in the State of Ohio who have a potential or confirmed medical handicap.  The field nurse consultants serve as liaisons with local health departments and community providers to the central office. These nurses are available to provide technical assistance and education/orientation to staff in local provider offices. 

Those who serve the central Ohio area are located in the central office.  Others are located in ODH District Offices.  See map assignments for more details.

BCMH Central Office (Columbus)                614-466-1700

Northwest District Office (Toledo)             419-245-2840

Southwest District Office (Dayton)            937-285-6250

Northeast District Office (Akron)               330-643-1300

Cambridge District Office                         740-432-3012

Jackson County Health Department           740-286-5094

Social Work Consultant

A licensed, registered social worker is also available and primarily works as the BCMH hospital coordinator.  The primary role of the hospital coordinator is to act as an advocate for families who may need assistance in obtaining service for their children with special health care needs.  The hospital coordinator works from Children’s Hospital Medical Center of Akron and MetroHealth Medical Center in Cleveland and can reached through the Northeast District Office.

Updated 3/1/2009