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Provider News

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


1/11/2019

NEW!  Effective 1-1-19: Ohio Department of Medicaid Treatment of Opiate Use Disorders Policy

12/17/2018

NEW! Effective immediately: Paramount Advantage - Unified Preferred Drug List – Delayed Indefinitely

11/29/2018

Our 2019 commercial formularies have been posted to the website.  

11/1/2018

Process for Medicaid Pharmacy Providers to submit MAC pricing appeals to CVS/caremark. 

9/27/2018

Opioid limits update for ProMedica Employee Health Plan (EHP).

9/18/2018

You may now submit professional claims through MyParamount! Learn more.

9/13/2018

Qualified Medicare Beneficiaries reminder 

8/29/2018

Our latest edition of Network News is available.  

8/9/2018

Prior Authorization updates for commercial members 

8/9/2018

Opioid prescribing information for Commercial members 

7/27/2018

EVV Notice from ODM

7/2/2018

Opioid prescribing information for Paramount Advantage members

6/18/2018

Claims processing changes coming 7/1/2018. Learn more! 

5/24/2018

Updated Opioid Prior Authorization Limits for Acute Pain - Paramount Advantage, Effective July 1, 2018.

5/17/2018

Online claims submissions and ODM behavioral health forum

5/16/2018

Changes to Rendering Provider NPI field in the detail lines of claims. 

4/26/2018

Paramount Advantage has launched a new member rewards program with the Cincinnati Bengals. Read more about the program here. 

4/12/2018

Updated ODM Consent/Certification Forms and Instructions

4/10/2018

We partnered with Medicaid plans in Ohio to bring you a Medicaid Resource Guide.

4/3/2018

Dawg Pound Healthy Rewards program details for our Paramount Advantage members

2/27/2018

IMPORTANT INFORMATION FOR PROVIDERS  

Effective March 1, 2018, Paramount Health Care will be changing our claim payment vendor from Change HealthCare to RedCard / VPay. Learn more here. See additional FAQs.

2/27/2018

Survey for Advantage PCPs 

1/19/2018

Clear Coverage authorization tool is being updated as of 2/1/2018. Please read.

12/1/2017

Opioid Prior Authorization updates beginning 1/1/18.

12/1/2017

Drug formularies for 2018 are posted on the website.

9/29/2017

Commercial Select Formulary Updates as of 11/1/17.

8/31/2017

Immediate release opioid prior authorization limits for Paramount Advantage members, effective October 1, 2017. 

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:

  • CMS’s Medical Coding Policies
  • AMA/CPT Coding Guidelines
  • Local and Regional CMS Policies
  • National Specialty Guidelines (coding and clinical)

Paramount’s medical payment policies focus on areas such as:

  • Bundling Edits including the National Correct Coding Initiative (NCCI)
  • Modifier Usage
  • Global Surgery Policies
  • Multiple Procedure Reduction
  • Units of Service Guidelines
  • Age and Gender Appropriateness

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.
10/22/2013 Synagis FAQ
4/16/2013 Provider Manual - Advantage