Tools and Education

Please find provider information, training and tools here:

Kit content


Provider training

Behavioral Health Re-Design Provider Presentation

To access the presentation, enter the password OH-Provider in the video display below. Note password is case sensitive.



CMS 1500 form

Transition of Care Quick Reference Guide

 

Home and Community-Based Waiver Program

For an overview of how the Waiver Service Program works, and applicable coding please refer to our Home and Community-Based Waiver Program Guide.

MyCare Ohio Home and Community-Based Services Waiver Program Guide


Cultural Competency

Culture is a major factor in how people respond to:

  • Health services
  • How they experience illness
  • How they access care
  • How they approach the process of getting well

Patient satisfaction and even positive health outcomes are directly related to good communication between a member and his or her provider.

A culturally competent provider effectively communicates with patients and understands their individual concerns. It is incumbent on providers to make sure patients understand their care regimen.

The Medicaid population in Ohio is approximately 32 percent African American and 2 percent Hispanic, according to 2012 data. Some live in long-term care and residential settings and participate in HCBS waiver programs. Each segment of this population requires special sensitivities and strategies to embrace cultural differences.

Training resources for our providers

As part of our cultural competency program, we provide information to our providers on the Office of Minority Health's web-based A Physician's Guide to Culturally Competent Care. The American Medical Association, American Academy of Family Physicians and the American College of Physicians endorse this program, which provides up to 9.0 hours of category 1 AMA credits at no cost.

In addition, as an Aetna Better Health physician, you have access to free online education modules provided by Aetna. Earn CMEs through courses on topics such as "Closing the Healthcare Gap and Quality Interactions". Visit Aetna Education to learn more.

Online Provider Dispute Instructions

Click here to read detailed instructions on how to submit a dispute using our secure Provider Web Portal.

To submit a dispute via mail visit our Forms section to print off and mail our standard Provider Dispute Form.

First-Tier, Downstream and Related Entities (FDR) Training

If you are a participating provider in our network, and you have not already done so, you and your staff must complete the “First-Tier, Downstream, and Related Entities Training” available at the link below.

Aetna Education

  1. Click on the link and type "FDR" in the search field. Then hit "Go."
  2. Select the "Toolbox of Resources for FDRs."

For more information on FDR Medicare Compliance, Aetna’s Code of Conduct, and Aetna Medicare’s Compliance and Procedures Policy, please refer to the links here.