A male doctor takes notes on a patient's chart

Learn about the Ohio Perinatal Quality Collaborative (OPQC) Progesterone Project and how to notify us when one of our members in your panel is pregnant.

When filing electronic Medicaid claims, please use Payer ID 61103 for your patients with coverage through Humana Healthy Horizons in Ohio. Please do not use Humana’s traditional Payer ID for fee-for-service claims (61101) when submitting Humana Healthy Horizons in Ohio Medicaid claims. Learn more about filing electronic claims .

Ohio Perinatal Quality Collaborative (OPQC) Progesterone Project

The Ohio Perinatal Quality Collaborative (OPQC) Progesterone Project's goal is to decrease premature births in Ohio before 32 weeks by 10%, by:

  • Identifying women with increased risk early in pregnancy
  • Starting treatment with progesterone

Learn more about the  Prematurity Prevention (Progesterone) Project .

Pregnancy Risk Assessment Communication

The Pregnancy Risk Assessment Communication (PRAF) is Ohio Medicaid’s preferred method for providers to notify the state and us of an individual’s pregnancy. You can submit this information via a paper or online form. The online form is called PRAF 2.0.

The PRAF 2.0:

  • Is the Ohio Department of Medicaid’s preferred notification of pregnancy
  • Is the only pregnancy notification that automatically
    • Updates Medicaid eligibility, which helps to
      • Prevent loss of Medicaid coverage during pregnancy
      • Prevent payment delays
    • Notifies us of a pregnancy
    • Notifies the home health agency of the need for progesterone
    • Assesses for additional patient needs
  • Results in the generation of a progesterone prescription that can be printed and faxed or taken to a pharmacy

Submit the PRAF 2.0

Get the paper PRAF 2.0

Instructions for completing the paper PRAF 2.0

Centers for Disease Control and Prevention HEAR HER campaign

The Centers for Disease Control and Prevention (CDC) launched recently an initiative called HEAR HER, which includes information, stories, and resources for providers with pregnant patients in their panel. Learn how preventing maternal deaths and complications starts with listening.

CDC HEAR HER campaign

Notification of birth

Please use our Notification of birth form to let us know when one of your patients with Humana Healthy Horizons® in Ohio coverage gives birth. Use this form to report a single birth as well as the delivery of twins or triplets. We will use this information to get a newborn Medicaid ID for each baby.

Notification of birth form

Appalachian Breastfeeding Network

Our members can call the Ohio statewide breastfeeding hotline 24/7, 365 days a year. This service will have Certified Lactation Specialists, Certified Lactation Counselors, and International Board Certified Lactation Consultants available to members for free.

Learn more about Appalachian Breastfeeding Network

 

Ohio Medicaid

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