CareSourceHigh ImpactAdministrative

[Ohio] National Provider Identifier (NPI) for Ordering, Referring and Prescribing (ORP) Providers

Published May 9, 2026

AI Summary

CareSource Ohio now requires National Provider Identifier (NPI) numbers for all ordering, referring, and prescribing (ORP) providers on claims and prior authorization requests. This affects any service where another provider ordered, referred, or prescribed the service being billed.

Action Required

Immediately: Billing team must update all claim submissions to include NPI numbers for ordering, referring, and prescribing providers. Update billing software to require ORP provider NPI entry before claim submission. Train staff to collect and verify NPI numbers from all referring providers. Claims missing ORP provider NPIs may be denied or delayed.

Plan Types

Medicaid

States

OH

Specialties

all-specialties