On February 1, 2023, the Ohio Department of Medicaid (ODM) launched the Next Generation Managed Care Plans. On the same day, the fiscal intermediary and electronic data interchange was implemented. Information regarding ODM’s Next Generation program can be found here.


Providers should verify eligibility at each member appointment. If you have an ODM approved established trading partner, you can check eligibility on ODM’s Provider Network Management website (PNM) or thru Availity Essentials.* If you do not have a relationship with an established ODM trading partner, you can check eligibility and benefits on Availity Essentials.


All claims and prior authorization requests should be submitted utilizing the member ID. If you have an established ODM approved trading partner, submit claims thru ODM’s fiscal intermediary via your approved trading partner. If you do not have an approved ODM trading partner, submit claims thru Availity Essentials.

Submit all prior authorization requests directly to Anthem Blue Cross and Blue Shield (Anthem) either thru Availity Essentials or by fax. Anthem’s payer ID for Ohio Medicaid claims is 0002937.


You can find more information on:

  • Verifying eligibility, submitting claims, and requesting prior authorization in our provider manual.
  • Availity Essentials at availity.com/Essentials-Portal-Registration:
    • To register for Availity Essentials training, select Help & Training | Get Trained from Availity’s home page once you have an Availity user ID and password.


The ODM logo and information for both Member and Provider Services is displayed on the back of the member ID card. If you have any questions, contact your Provider Relationship Account Manager directly, or submit your question to our shared email at OhioMedicaidProvider@anthem.com.

* Availity, LLC is an independent company providing administrative support services on behalf of the health plan.

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March 2023 Anthem Provider News - Ohio