buckeye health plan credentialing Preview on Page 1

Buckeye health facility form 2026

The document is a credentialing application for behavioral health facilities and agencies, outlining the necessary steps and required documentation for the credentialing process. It includes instructions for submission, a checklist of required documents such as staff rosters, accreditation letters, licenses, and insurance policies. The application also covers various facility types, accreditation information, administrative details, and legal disclosures related to professional liability and compliance. Additionally, it emphasizes the responsibility of the facility to ensure all practitioners are qualified and to notify Buckeye Health Plan of any changes.

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Click ‘Get Form’ to open the buckeye health facility form in the editor.
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.
Complete the 'Accreditation Information' section by indicating whether your facility is accredited and providing details about the accrediting agency.
In the 'Licensure and Certification Information' section, list all relevant licenses and certifications, including their issuing entities and expiration dates.
Fill in the 'Location' sections for each facility, ensuring to include addresses, contact information, and operational hours.
Review the 'Sanctions & Disclosure questions' carefully. Answer each question truthfully and attach any necessary explanations on a separate sheet if applicable.
Finally, sign the application at the bottom. Use our platform's signature feature to add your signature electronically for convenience.

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What is MyCare insurance?

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 do I apply for Buckeye Health Plan?

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.

Is Buckeye only Medicaid?

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.

What is Ohio State Medicaid called?

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.

Is MyCare, Ohio ending?

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.