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CommercialReimbursementMedium impact

[Ohio] Reimbursement policy reminder: Bundled Services and Supplies — Facility

Anthem BCBS·OH, CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, WI·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Days to comply

Summary

Anthem Blue Cross and Blue Shield is reminding providers that the Bundled Services and Supplies — Facility reimbursement policy applies to both inpatient and outpatient facility fees effective July 1, 2026. Providers are prohibited from balance-billing members under this policy, and billing teams must ensure compliance with bundled service requirements to avoid claim denials and member disputes.

Action Required

Action needed
By July 1, 2026: Billing team must review the complete Bundled Services and Supplies — Facility reimbursement policy on the Anthem provider website (providernews.anthem.com/ohio). Verify that all facility fee billing for both inpatient and outpatient services complies with bundling requirements. Audit current billing processes to ensure no balance-billing occurs for bundled services. Update billing software rules and provider education materials to reinforce the balance-billing prohibition. Non-compliance will result in claim denials and potential member refund obligations.