Paramount wants to make your job easier. You can now stay up to date on Paramount news and updates, as well as government announcements, by visiting us here.
News from Paramount
NEW! We are updating the look of our website. Stay tuned for a new version coming soon!
NEW! Effective 1-1-19: Ohio Department of Medicaid Treatment of Opiate Use Disorders Policy
Effective immediately: Paramount Advantage - Unified Preferred Drug List – Delayed Indefinitely
Our 2019 commercial formularies have been posted to the website.
Process for Medicaid Pharmacy Providers to submit MAC pricing appeals to CVS/caremark.
Opioid limits update for ProMedica Employee Health Plan (EHP).
You may now submit professional claims through MyParamount! Learn more.
Qualified Medicare Beneficiaries reminder
Our latest edition of Network News is available.
Claims processing changes coming 7/1/2018. Learn more!
Updated Opioid Prior Authorization Limits for Acute Pain - Paramount Advantage, Effective July 1, 2018.
Paramount Advantage has launched a new member rewards program with the Cincinnati Bengals. Read more about the program here.
We partnered with Medicaid plans in Ohio to bring you a Medicaid Resource Guide.
Dawg Pound Healthy Rewards program details for our Paramount Advantage members
IMPORTANT INFORMATION FOR PROVIDERS
Drug formularies for 2018 are posted on the website.
|8/23/2017||Flu shot information is available for 2017/2018.|
|6/21/2017||Electronic claim adjustments are now accepted. Please review our announcement for more details.|
|6/20/2017||Our fax numbers are being updated as of 6/26/2017. Please review our updated fax numbers for Utilization and Care Management.|
|2/7/2017||Please review the Ohio Department of Medicaid notice regarding ICD-10 diagnosis codes for pregnancy|
|2/1/2017||The latest updates to the Commercial and Marketplace Formularies are effective March 1, 2017.|
|12/19/2016||The latest edition of Paramount Network News is available now.|
|12/1/2016||Paper Claims Submission Policy Update|
|11/30/2016||IMPORTANT INFORMATION FOR PROVIDERS
Paramount regularly reviews and updates our medical payment and claims processing policies. Paramount’s goal is to ensure that the medical payment policies reflect current input from highly respected sources as well as using Paramount’s historical policies. Those respected sources include:
Paramount’s medical payment policies focus on areas such as:
Updated editing will include bundling logic, NCCI edits, modifier usage, global surgery package guidelines, multiple procedure reduction and units of service across claims.
If you have further questions, please contact your Provider Relations Representative at: (419) 887-2535 or (800) 891-2564
|10/18/2016||Flu Shot information (removed; please refer to current years information) and Coding/Billing Guide|
|10/5/2016||IMPORTANT! Prior Authorization requests updates, effective 10/5/2016|
|9/29/2016||Commercial and Marketplace Exchange Formulary Updates Effective 10/15/2016|
|8/24/2016||Paramount Advantage formulary updates effective September 2016.|
|1/25/2016||Attention Labs: Effective April 18, 2016, register clinical laboratories and molecular diagnostic tests in the McKesson Diagnostics Exchange (DEX)|
|12/11/2015||Check out the 2016 Prescription Drug Formulary & Utilization Management changes for Paramount formularies and drug plans.|
|11/19/2015||Preferred Drug Lists are now available for 2016.|
|9/25/2015||Skilled Nursing Pre-Certification Form.|
|9/2/2015||Flu shot information for 2015/2016 (removed; please refer to current years information)|
|7/14/2015||The summer edition of Network News is now available.|
|7/13/2015||ICD-10 is coming soon. Check out our ICD-10 page, and our most recent bulletin on Gesation diagnosis codes for Medicaid.|
|6/15/2015||Paramount has updated its provider portal. DIRECT has been replaced with MyParamount. Check it out today!|
|12/23/2014||IMPORTANT! Paramount has a new Pharmacy Benefit Manager effective 1/1/15 - CVS/caremark! Please read this letter for more information.|
|7/21/2014||Respite Care guidelines for Advantage members.|
|11/14/2013||Paramount is going electronic – In order to be compliant with ACA requirements to pay providers electronically, all payments made on or after December 13, 2013 will be processed via Electronic Funds Transfer or Virtual Credit Card.|
|4/16/2013||Provider Manual - Advantage|