Anthem Blue Cross and Blue Shield claim submission process for participating and non-participating providers

• All Ohio Medicaid claims with Anthem Blue Cross and Blue Shield (Anthem) must be submitted electronically through the Ohio Department of Medicaid’s (ODM) Fiscal Intermediary (FI) via an ODM authorized electronic data interchange (EDI) trading partner using EDI payer ID# 0002937.
• Providers can submit their ODM claims electronically to Availity Essentials^* by submitting with the payer ID# 0002937.
• If a provider does not use an ODM authorized EDI trading partner, claims must be entered on the Availity Essentials website via Direct Data Entry at Availity.com. Once the claim is entered, Availity will route the claim through ODM’s Fiscal Intermediary (FI) for processing.
• If a provider uses the Ohio Commercial EDI payer ID# for Ohio Medicaid claims with Anthem, the claim will be rejected.
• Paper claims will not be accepted.

For the most up-to-date information, please visit our provider website at https://providers.anthem.com/oh.

If you have any additional questions, please reach out to our dedicated Health Care Networks team at OhioMedicaidProvider@anthem.com.