Medicare AdvantageAdministrativeHigh impact
[Ohio] Take action: Use no-cost electronic claims to avoid paper administrative fees
Anthem BCBS·OH·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Aug 3, 2026
Summary
Anthem Blue Cross and Blue Shield is implementing a $5 administrative fee for paper-submitted claims and printed checks effective October 1, 2026 (Medicare Advantage) and November 1, 2026 (Commercial). The fee applies when net paid amounts are $10 or greater. Billing teams must transition to electronic claim submission via Availity to avoid these fees.
Action Required
By September 15, 2026: Billing team must ensure all claims for Anthem Medicare Advantage patients are submitted electronically through Availity Essentials. By October 15, 2026: Billing team must ensure all claims for Anthem Commercial patients are submitted electronically through Availity Essentials. Immediately: Register for Availity Essentials at https://Availity.com (no cost) if not already registered; contact Availity Client Services at 800-AVAILITY for registration questions. Audit current claim submission processes to identify any paper claims currently being submitted. Update billing system workflows to default to electronic submission and flag any paper claims for manual review before submission. Train billing staff on electronic submission requirements. Implement monitoring to track paper claims submitted after effective dates to ensure compliance and identify any system failures. Providers cannot bill patients for these fees. Failure to submit electronically will result in $5 per-claim charges that reduce practice revenue.