Electronic data interchange (EDI)


Anthem Blue Cross and Blue Shield (Anthem) providers may submit claims, eligibility inquiries, claim status inquiries, and associated attachments using electronic data interchange (EDI) through an authorized Ohio Department of Medicaid (ODM) trading partner.

EDI lets you:

  • Process claims faster by submitting coordination of benefits electronically and fixing errors early with in-system notification and correction
  • Reduce overhead and administrative costs by eliminating paper claim submissions

HIPAA transaction codes

Providers can use the following HIPAA transaction codes and submit through the Ohio Department of Medicaid:
  • Healthcare Claim: Professional (837P)
  • Healthcare Claim: Institutional (837I)
  • Healthcare Claim: Dental (837D)
  • Healthcare Eligibility Benefit Inquiry and Response (270/271)
    • Availity can be used for your real-time requests
  • Healthcare Services Prior Authorization (278)
  • Healthcare Claim Payment/Advice (835)
  • Healthcare Claim Status Request and Response (276/277)
  • Medical Attachments (275)

* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.

OH_EDI_Thumbnail

EDI submissions and enrollment

All electronic data interchange (EDI) transmissions for Ohio Medicaid Managed Care membership must be submitted to the Ohio Department of Medicaid (ODM) using approved trading partners. Please note – Availity* is a trading partner with ODM and medical claims can be submitted using payer ID 0002937.

Registration and contact information

OH_double-email_Icon

Email: usomesedisupport@deloitte.com

Phone

Call the Integrated Health Desk (EDI): 800-686-1516

Note: Select option 3 to speak to representative concerning EDI questions and enrollment.

Payer ID

Payer IDs route EDI transactions to the appropriate payer.

EDI payer IDs:

  • 0002937 — Medical claims — Anthem/Ohio Department of Medicaid
  • D002937 — Dental claims — Anthem/DentaQuest*
  • V002937 — Vision claims — Anthem/EyeMed*
  • T002937 — Transportation claims — Anthem/Access2Care*

 

Electronic remittance advice (ERA)

The 835 eliminates the need for paper remittance reconciliation. The ERA 835 must be registered with ODM for the Ohio Medicaid plan. Please fill out the 835 trading partner form and submit your EDI registration to ODM.

Providers can access their ERAs through  Availity Essentials .

Note: If you use a clearinghouse or vendor, please work with them on ERA registration and receiving your ERAs with ODM. Commercial policies with Anthem Blue Cross and Blue Shield (Anthem) will continue to be registered and managed by Availity.

Electronic funds transfer (EFT)

Electronic claims payment through electronic funds transfer (EFT) is a secure and fast way to receive payment, reducing administrative processes. EFT deposits are assigned a trace number that is matched to the 835 electronic remittance advice (ERA) for simple payment reconciliation.

Use EnrollSafe to register and manage EFT account changes.

Note: If a provider does not enroll in EFT, they will receive a paper check or virtual card.

Contact information

For more information on EDI, please refer to your provider manual , contact your Provider Services representative, or reach out to the Ohio Department of Medicaid’s EDI services.

Provider Services

Phone

Phone: 844-912-1226

EDI Customer Service

Phone

Monday to Friday 8 a.m. through 4:30 p.m. EST
Phone: 844-324-7089
 

OH_double-email_Icon

EDI Technical Assistance

Phone

Monday to Friday 8 a.m. through 4:30 p.m. EST
Phone: 844-324-7089

OH_double-email_Icon

Provider tools & resources

Join our network

We’re glad you’re interested in joining the Anthem network. We have a diverse network of exceptional healthcare professionals who ensure our members have uninterrupted access to the support they need.