Buckeye Health Plan provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.buckeyehealthplan.com/providers/resources.html |
|---|---|
| Payer contact reference | 1-866-296-8731The 2026 Medicaid manual identifies 866-296-8731 as Provider Services. The old 866-246-4356 appears in utilization-management and peer-to-peer contexts, not as the general claims contact. Other products and EDI setup have separate routes; no phone call was made. |
| Claims payer ID | The 2026 Medicaid manual assigns 0004202 to Ohio Medicaid 837P/I through ODM’s fiscal intermediary. The current electronic-transactions page separately assigns Next Generation MyCare 0021583 effective January 1, 2026 by received date, not service date. 68069 appears for other products/older MyCare routes; dental/vision routes differ. |
| Eligibility payer ID | The reviewed sources do not establish 68069 as one universal 270/271 or 835 enrollment identifier. Verify each product and transaction; public portal functions are not end-to-end X12 certification. |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Buckeye’s electronic-transactions page describes PaySpan ERA/EFT and product-specific EDI routes. The copied 68069 scalar is not established as one universal ERA enrollment value; verify the selected product and receiver. |
| Timely filing | Ohio Medicaid: 365 days from service/discharge; agreement scope |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- The 2026 Medicaid manual identifies 866-296-8731 as Provider Services. The old 866-246-4356 appears in utilization-management and peer-to-peer contexts, not as the general claims contact. Other products and EDI setup have separate routes; no phone call was made.
- The 2026 Buckeye Medicaid manual gives participating providers 365 days from service or discharge for clean initial, corrected and voided claims unless the provider agreement differs. This Medicaid rule is not a universal deadline for Ambetter, Medicare or every MyCare product.
- This registry has not established a payer-specific appeal ladder for Buckeye Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- Buckeye’s electronic-transactions page describes PaySpan ERA/EFT and product-specific EDI routes. The copied 68069 scalar is not established as one universal ERA enrollment value; verify the selected product and receiver.
Buckeye Health Plan at a glance
| Legal name | Buckeye Health Plan, Inc. |
|---|---|
| Also known as | Buckeye Community Health Plan |
| Category | Medicaid MCO |
| Parent organization | Centene Corporation |
| Claims payer ID | The 2026 Medicaid manual assigns 0004202 to Ohio Medicaid 837P/I through ODM’s fiscal intermediary. The current electronic-transactions page separately assigns Next Generation MyCare 0021583 effective January 1, 2026 by received date, not service date. 68069 appears for other products/older MyCare routes; dental/vision routes differ. |
| Eligibility (270/271) payer ID | The reviewed sources do not establish 68069 as one universal 270/271 or 835 enrollment identifier. Verify each product and transaction; public portal functions are not end-to-end X12 certification. |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Buckeye’s electronic-transactions page describes PaySpan ERA/EFT and product-specific EDI routes. The copied 68069 scalar is not established as one universal ERA enrollment value; verify the selected product and receiver. |
| NAIC company code | Not established in this registry |
| States covered | Ohio |
| Members covered | ~360k members |
| Provider resource entry point | https://www.buckeyehealthplan.com/providers/resources.html |
| Provider phone | 1-866-296-8731The 2026 Medicaid manual identifies 866-296-8731 as Provider Services. The old 866-246-4356 appears in utilization-management and peer-to-peer contexts, not as the general claims contact. Other products and EDI setup have separate routes; no phone call was made. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Buckeye Health Plan
The 2026 Buckeye Medicaid manual gives participating providers 365 days from service or discharge for clean initial, corrected and voided claims unless the provider agreement differs. This Medicaid rule is not a universal deadline for Ambetter, Medicare or every MyCare product.
| Submission type | Window |
|---|---|
| Initial claim reference | Ohio Medicaid: 365 days from service/discharge; agreement scope |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Buckeye Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Buckeye Health Plan provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Buckeye Health Plan
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Buckeye Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Buckeye Health Plan. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Buckeye Health Plan
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Buckeye Health Plan volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | The 2026 Medicaid manual assigns 0004202 to Ohio Medicaid 837P/I through ODM’s fiscal intermediary. The current electronic-transactions page separately assigns Next Generation MyCare 0021583 effective January 1, 2026 by received date, not service date. 68069 appears for other products/older MyCare routes; dental/vision routes differ. |
| 270 / 271 eligibility | Listed in registry; verify current scope | The reviewed sources do not establish 68069 as one universal 270/271 or 835 enrollment identifier. Verify each product and transaction; public portal functions are not end-to-end X12 certification. |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Buckeye’s electronic-transactions page describes PaySpan ERA/EFT and product-specific EDI routes. The copied 68069 scalar is not established as one universal ERA enrollment value; verify the selected product and receiver. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
What revenue cycle teams should verify before submitting claims
- Ohio Medicaid batch837 submissions use ODM’s fiscal intermediary; do not direct them to a generic insurer route.
- The 2026 Next Generation MyCare effective rule is based on received date. Retain older product rows only as explicitly contextual, not current universal routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
era_payer_id, field_status, filing_rule, payer_ids, payer_ids.claims, payer_ids.eligibility, payer_ids.era, provider_phone, timely_filing_days, timely_filing_source_url, transaction_scope — Buckeye2026 Medicaid Provider Manual
Source comparison: 2026-09-18
Source scope: Medicaid 837P/I0004202 uses ODM’s fiscal intermediary;365 days from service/discharge unless agreement. Dental/vision routes differ. Provider Services 866-296-8731 differs from utilization-management 866-246-4356. Locator: Physical PDF 83/printed 82 ODM intermediary; PDF 85/printed 84 timely claims; PDF 6 Provider Services and PDF 75 UM read as text only Version: 2026 manual, amended January 6, 2026 filename; February 6 metadata is not a new policy date. Retrieval: content_read; actual_public_pdf_download_text_and_scoped_visual_review. These pages actually rendered and inspected with view_image; other pages text-only or not reviewed. Not a whole-document review. This is a partial source comparison, not whole-field or whole-record approval.
Primary source for era_payer_id, field_status, filing_rule, payer_ids, payer_ids.claims, payer_ids.eligibility, payer_ids.era, provider_phone, timely_filing_days, timely_filing_source_url, transaction_scope — buckeye2026 medicaid provider manualera_payer_id, payer_ids, payer_ids.claims, payer_ids.eligibility, payer_ids.era, transaction_scope — Buckeye electronic transactions
Source comparison: 2026-09-18
Source scope: 0004202 is Medicaid medical; Next Generation My Care0021583 applies from January 1, 2026 by received date, not service date.68069 is listed for other products/older My Care; ERA enrollment is separate. Locator: Payer-ID table, January 1, 2026 effective block and Pay Span section Version: HTML contains mixed historical2023/2024rows and explicit 2026 effective block; no new whole-page publication date. Retrieval: content_read; public_web_read. This is a partial source comparison, not whole-field or whole-record approval.
Primary source for era_payer_id, payer_ids, payer_ids.claims, payer_ids.eligibility, payer_ids.era, transaction_scope — buckeye electronic transactions
Not checked in this pass: Unresolved fields from immutable field inventory: aka, appeal_levels, category, common_denial_risks, display_name, electronic_claims_supported, legal_name, lives_covered_millions, naic, parent_org, payer_ids, portal_url, prior_auth_required_codes_sample, quickintell_workflow_fit, record_scope, source_review, states_covered, supports_278, supports_279_271; Whole-record approval, current legal entity/ownership, enrollment and complete insured geography; Every agreement, product, claim type, jurisdiction, filing/appeal exception and clinical authorization policy; Current transaction-specific enrollment/capabilities and authenticated portal behavior; unknown does not mean unavailable; QuickIntell integrations/outcomes, accountable approval and historical April2026 DataForSEO demand; last_reviewed/reviewed_by and prior field-level comparison dates remain unchanged.
Sources used for this guide
State coverage
Buckeye Health Plan operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Buckeye Health Plan
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Buckeye Health Plan; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Buckeye Health Plan; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Buckeye Health Plan before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Buckeye Health Plan
Where is the Buckeye Health Plan provider portal?
Use https://www.buckeyehealthplan.com/providers/resources.html as a starting point for Buckeye Health Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Buckeye Health Plan?
The 2026 Buckeye Medicaid manual gives participating providers 365 days from service or discharge for clean initial, corrected and voided claims unless the provider agreement differs. This Medicaid rule is not a universal deadline for Ambetter, Medicare or every MyCare product.
What is the Buckeye Health Plan payer ID?
Claims: The 2026 Medicaid manual assigns 0004202 to Ohio Medicaid 837P/I through ODM’s fiscal intermediary. The current electronic-transactions page separately assigns Next Generation MyCare 0021583 effective January 1, 2026 by received date, not service date. 68069 appears for other products/older MyCare routes; dental/vision routes differ.. Eligibility (270/271): The reviewed sources do not establish 68069 as one universal 270/271 or 835 enrollment identifier. Verify each product and transaction; public portal functions are not end-to-end X12 certification.. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Buckeye’s electronic-transactions page describes PaySpan ERA/EFT and product-specific EDI routes. The copied 68069 scalar is not established as one universal ERA enrollment value; verify the selected product and receiver.. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does Buckeye Health Plan accept electronic claims?
Verify Buckeye Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Buckeye Health Plan denial?
This registry has not established a payer-specific appeal ladder for Buckeye Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Buckeye Health Plan prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Buckeye Health Plan provider phone number?
This registry lists 1-866-296-8731 as a contact reference for Buckeye Health Plan. The 2026 Medicaid manual identifies 866-296-8731 as Provider Services. The old 866-246-4356 appears in utilization-management and peer-to-peer contexts, not as the general claims contact. Other products and EDI setup have separate routes; no phone call was made.
Automate workflows around Buckeye Health Plan requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Buckeye Health Plan's current published documents before submission. CPT® is a registered trademark of the American Medical Association.