Your Trusted Billing Partner

RevUp Billing helps with Ohio's Next Generation Medicaid billing. We are an ODM billing solution for practices.
Power up your billing with our partnership.
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Streamline Your Billing Process

Optimize your practice's work flow with our experienced ODM billing solutions. Focus on patients, not paperwork.

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Beneficial Collaboration

We have many years of experience in the medical billing industry and understand that every provider has unique needs and requirements. We collaborate with your practice in order to save you time & money.

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An Ohio Company

RevUp Billing is owned and operated in the state of Ohio. We specifically tailor our services to meet the specific needs of healthcare practitioners who work with the Next Generation Ohio Medicaid system.

Help with PNM & MCOs

As a professional billing solution, we monitor and assist your practice with any ODM-generated denials. RevUp Billing also helps remedy issues with Centralized Credentialing and ODM roster updates.

Help with PNM, OMES & EDI

Ohio Medicaid has implemented the Next Generation managed care plans with the goal of streamlining claims and prior authorizations for providers. RevUp Billing delivers experienced billing services for Provider Network Management (PNM) claims.

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Knowledgeable Ohio-based Billing Services

RevUp Billing partners with your medical practice. We help providers navigate the regulatory challenges of the Ohio Medicaid system as well as the Ohio Department of Mental Health and Addiction Services (OhioMHAS).

Skilled Assistance

Our professional and friendly staff reduces your amount of administrative paperwork from the Ohio Next Generation Medicaid system.

Claims Testing

RevUp Billing performs focused testing and monitoring of claim submissions with our practice management system and clearing house.

Helpful Guidance

We provide guidance on statewide billing and credentialing mandates. This helps clinics and practices optimize their workflows while staying in compliance.


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Next Generation Ohio Medicaid: MCOs

RevUp Billing provides professional billing services for medical practitioners who use Ohio's Next Generation Medicaid system.

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Questions about Next Generation Medicaid:

The Next Generation of Ohio Medicaid program's EDI is designed to increase transparency and visibility of care services. As part of the Ohio Medicaid Enterprise System, the company Deloitte is the EDI vendor and takes responsibility for all EDI HIPAA x12 transactions.

The new PNM modular component system will replace the Medicaid Information Technology System (MITS). ODM's Next Generation PNM module is designed to deliver a streamlined process for submitting and monitoring insurance claims. The PNM module will also allow providers to submit and track prior authorizations, fee-for-service claims as well as other administrative tasks.

All managed care members will need new Next Generation ID cards. However, if a member actively made a new plan selection or was previously enrolled in Medicaid Fee-for-Service and recently enrolled in managed care. These members will continue to use their existing ID card. For members who made a new plan selection during the open enrollment period, they will receive a new Next Generation ID card. Next Generation Medicaid managed care does not apply to members enrolled in MyCare Ohio plans.

There are now a total of seven MCOs (managed care organizations) to choose from in the ODM Next Generation Medicaid system. The seven are MCOs are as follows: •AmeriHealth Caritas Ohio, Inc. •Anthem Blue Cross and Blue Shield •Buckeye Community Health Plan •CareSource Ohio, Inc. •Humana Healthy Horizons in Ohio •Molina Healthcare of Ohio, Inc. •UnitedHealthcare Community Plan of Ohio, Inc.

Ohio healthcare providers are not required to contract with all of the Next Generation managed care organizations. Healthcare providers can pick and choose which Next Generation MCO they would like to contract with for services.

Ohio Next Generation Medicaid News

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Next Generation of Ohio Medicaid: Transitioning from MITS to PNM

There have been some challenges in the transition from MITS (Medicaid Information Technology System) to the PNM (Provider Network Management) module.

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