Job & Family Services - Ohio Health Plans
Ohio Medicaid

Ohio's Medicaid Program > Providers > ODJFS Trading Partners

Required Forms & Technical Letters

ODJFS Trading Partner Agreement
Submission of the ODJFS Trading Partner Agreement represents a request by a trading partner to enter into contractual relationship with ODJFS. As such, we ask that you follow the directions below when completing it for your organization.

  • We suggest that your attorney review it.
  • It is not valid if you amend, redact or change it in any manner.
  • It must be signed by someone in your organization who is authorized to legally bind the organization.

Download the ODJFS Trading Partner Agreement here.

Please sign two originals with blue ink and mail the complete signed documents to:

Ohio Department of Job and Family Services
Office of Contract and Acquisitions
Trading Partner Agreements
30 East Broad Street, 31 st Floor
Columbus, Ohio 43215

Call the ODJFS Office of Contracts and Acquisitions at (614) 728-5693 with any questions.

Other Required Forms
All potential trading partners must fill out the following forms: 

Technical Letters
Medicaid tape billing instructions for National Standard Form (NSF)and Flat File Versions IV and VI: (Note: These are for Sister Agencies only.)