Buckeye community health plan overpayment form

  • Is Buckeye considered Medicaid?

    Buckeye Health is a Medicaid plan for adults and children in Ohio.
    Eligibility is determined by family size and income.
    Buckeye Member Services (1-866-246-4358 OR TDD/TTY: 1-800-750-0750) can answer questions about Buckeye Health Plan..

  • Please fill out the below form or contact us at 1-866-246-4358.
    Your inquiry will be reviewed.
    A Buckeye Health Plan representative may contact you regarding your inquiry.

Claims

ECHO Health Enrollment– Submit this form to enroll with ECHO Health, our electronic funds transfer partner.

Medical Prior Authorization

NavigateMedical Prior Authorization Form– Submit this form to request prior authorization for a medical procedure.

Member-Related Forms

Care Management Referral Form– This form can be submitted using the Provider Portal.


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