Reminders: Electronic Remittance Advice (835) and Electronic Claim Submissions (837)

Beginning February 1, 2023, all electronic data interchange (EDI) transactions for Ohio Medicaid Managed Care (OMMC) membership must be submitted and retrieved by the Ohio Department of Medicaid (ODM). This includes Claims (837) and the Electronic Remittance Advice (835).

Below are some reminders on using EDI for this policy.

Electronic Remittance Advice (835)

To receive your ERA 835s, you must be registered with both ODM for the OMMC policy and Availity*. Once registration is received, Anthem Blue Cross and Blue Shield (Anthem) will begin creating the 835s.

Note: If your provider organization is registered and receiving 835s for the Ohio Commercial policy from Availity, a separate registration is required with ODM.

Below is the link to submit an 835 registration to ODM.

https://bit.ly/3pOCgo6

Note: If you use a clearinghouse/billing vendor, please work with them on ERA registration and receiving your ERAs from ODM.

Provider organizations can retrieve a copy of the paper remittance advice two ways:

1. Availity Essentials— PDF versions of the paper remittance are available in Remit Inquiry.
   Log in to Availity Essentials > select Ohio > select Payer Spaces > Anthem Blue Cross Blue Shield tile > Remit Inquiry Application.
2. The Provider Network Management (PNM) Portal— A PDF version is available in addition to the 835.

Electronic submitted transactions (EST) — Claims (837), Batch Eligibility & Claim Status, and Prior Authorizations

There are two ways your organization or EDI vendor can submit OMMC transactions:

1. Submit directly to Ohio Department of Medicaid’s vendor Deloitte. As part of ODM’s partnership with Deloitte Consulting LLP for EDI services, trading partners will need to establish new connectivity with Deloitte. Below is a link for more information.
   https://bit.ly/3Ilit6l
2. Submit to Availity using EDI payer ID 0002937. Availity is a trading partner with ODM’s vendor Deloitte and will route and deliver OMMC electronic transactions on behalf of your organization or EDI vendor.

Note: If you use a clearinghouse/billing vendor, please validate the payer ID used to submit your EDI transactions to them. Sometimes it differs than the one communicated. (Example: 0002937)

Contact information

ODM EDI support:

• Email: OMESEDIsupport@medicaid.ohio.gov
• Phone: 800-686-1516, Option 4 available Monday through Friday, 7 a.m. to 7 p.m..; Saturday and Sunday, 8 a.m. to 5 p.m.