MedicaidAdministrativeHigh impact
[Ohio] Ohio Medicaid Managed Care and Anthem MyCare Ohio: ASC claims accepted on CMS-1500 and UB-04 — resubmit denied claims
Anthem BCBS·OH · General Surgery, Bariatric Surgery, Cardiothoracic Surgery +4 more·Government Programs
Effective date
Aug 3, 2026
We identified it
Aug 5, 2026
Summary
Anthem has updated its claims system to accept ASC (ambulatory surgery center) claims on both CMS-1500 and UB-04 forms. Previously denied claims due to incorrect billing form should be resubmitted. This resolves a systemic configuration error that was causing claim denials based on form type.
Action Required
Immediately: Billing team must identify and resubmit all previously denied ASC claims from Ohio Medicaid and Anthem MyCare Ohio that were rejected for incorrect billing form. Review the Claims Payment Systemic Error (CPSE) report referenced in the policy for specific claim details. Update internal billing guidelines to confirm that both CMS-1500 (HCFA) and UB-04 (CMS-1450) are now acceptable for ASC claims to Ohio Medicaid plans. Contact OhioMedicaidProvider@anthem.com if clarification is needed on claim submission requirements. Failure to resubmit previously denied claims may result in lost revenue.