Medicaid

Claims

Claims submission information: Please see our Provider General Billing Information and Guidelines within the Provider Manual.

Medicaid Fiscal-Intermediary

New Buckeye Payer IDs effective 2/1/23 as follow: 

• 0004202 BUCKEYE OHIO MEDICAID (837 P & I ONLY)
• V004202 BUCKEYE/ENVOLVE VISION
• D004202 BUCKEYE/ENVOLVE DENTAL (837 Dental)

Physicians, other licensed health professionals, facilities, and ancillary providers contract directly with Buckeye for payment of covered services. If you are an out-of-network provider seeking payment for claims for emergency, post-stabilization, and any other services authorized by Buckeye, please review these guidelines below.

It is important that providers ensure Buckeye has accurate billing information on file.

Please provide accurate information as follows:

• Provider name (as noted on his/her current W-9 form)
• Physical location address
• Billing name and address (if different)
• Tax Identification Number

Claims eligible for payment must meet the following requirements:

• The member is effective on the date of service;
• The service provided is a covered benefit under the member’s contract on the
• date of service; and
• Referral and prior authorization processes were followed, unless the service was an emergency service.

• For detailed information, please refer to the Provider Manual or, call Buckeye’s Provider Services Department at 866-296-8731. 
• Payment for service is contingent upon the service being provided to treat an emergency, or the service was in compliance with referral and prior authorization policies and procedures, as well as the billing guidelines.
• For Buckeye members, all claims and encounters should be submitted to the general claim department address listed in our Provider Manual, unless it’s a specialty service as noted: