Buckeye health facility form 2026

Get Form
buckeye health plan credentialing Preview on Page 1

Here's how it works

01. Edit your buckeye health plan credentialing online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send buckeye health plan application via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out buckeye health facility form with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the buckeye health facility form in the editor.
  2. Begin by filling out the 'Legal Name' and 'Facility Type' sections. Ensure you select the appropriate type from the provided options, such as Hospital or Outpatient Clinic.
  3. Complete the 'Accreditation Information' section by indicating whether your facility is accredited and providing details about the accrediting agency.
  4. In the 'Licensure and Certification Information' section, list all relevant licenses and certifications, including their issuing entities and expiration dates.
  5. Fill in the 'Location' sections for each facility, ensuring to include addresses, contact information, and operational hours.
  6. Review the 'Sanctions & Disclosure questions' carefully. Answer each question truthfully and attach any necessary explanations on a separate sheet if applicable.
  7. Finally, sign the application at the bottom. Use our platform's signature feature to add your signature electronically for convenience.

Start using our platform today to complete your buckeye health facility form easily and for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
NYL My Care from New York Life Insurance Corporation is a simple way to provide long-term care coverage if you need it in the future. It offers a range of pre-set benefit options and pairs you with a care planner to help you get the kind of care you want.
How to Apply ONLINE: Go to the Ohio Benefits website this is the fastest way! PHONE: Call the Ohio Medicaid Consumer Hotline at 1-800-324-8680. IN PERSON: Visit your County Department of Job and Family Services office. Find your county office at the JFS website.
Buckeye Health Plan is contracted with the Ohio Department of Medicaid as a care coordination plan, and has been providing Medicaid and other government health services since 2004.
MyCare Ohio MyCare Ohio. MyCare Ohio is a system of managed care plans selected to coordinate physical, behavioral, and long-term care services for individuals over the age of 18 who are eligible for both Medicaid and Medicare.
No. MyCare Ohio is not ending, but it is transitioning to Next Generation MyCare in January 2026. Until then, your benefits, providers, and coverage will remain the same.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance

People also ask

Buckeye is committed to helping our members get and stay healthy. Thats why we offer Ohio health insurance plans that cover every stage in life, including medical, behavioral health, pharmacy, dental, vision and so much more.
Buckeye Health Plan MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. Those who meet the rules can join our plan to can get benefits from one single health plan.
MyCare Ohio is a managed care program designed for Ohioans who receive both Medicaid and Medicare benefits.

Related links