Provider Billing

HCBS Waiver providers are required to submit claims to DODD in order to receive payment. The Southern Ohio Council offers billing services to independent providers. This service includes data entry into Gatekeeper and transmitting the claims through the e-MBS (electronic Medicaid Billing System). Some technical assistance and monthly billing histories also are provided as part of this service. Payment for services may be made by sending check or money order or by paying online by credit card.

The cost for this service is an initial $15 set-up fee per individual being served (both Level I and IO).

For Individual Options (I.O.) Waiver Providers there is a monthly charge of $35.00 per individual served by the provider, paid monthly with the first claim of the month (for the first three months of service). Thereafter, a processing fee of $150 per individual served by the provider will be due, paid quarterly with the first claim of the quarter. 

A yearly processing fee of $410 per IO wavier individual submitted with the first claim of the contracted year (savings of $10).

A quarterly processing fee of $35 for Level I Waiver individuals (Covers 1-3 individuals with an additional $10 per individual over 3. For example, 4 individuals = $45/quarter, 5 individuals = $55/quarter, etc.) 

For additional information or to set up provider billing services, please contact our office at 740-775-5030.