Summary
Effective February 1, 2027, Anthem Blue Cross and Blue Shield will not process claims for Ohio Medicaid and MyCare Ohio members from providers who are not registered and active in ODM's Provider Network Management (PNM) system. Your practice must verify enrollment status, confirm active status, and ensure all demographic and enrollment information is current in PNM before the deadline to avoid claim denials and service interruptions.
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What to do
Action · 5 steps
01Before February 1, 2027: Billing team must verify that the practice is registered and active in ODM's Provider Network Management (PNM) system.
02Confirm all demographic, enrollment, and organizational affiliation information is current and accurate in PNM.
03Complete any required enrollment, revalidation, or maintenance activities in PNM before submitting claims.
04Contact the provider relationship management representative or email ohiomedicaidprovider@anthem.com with questions (or ohltssproviderrelations@anthem.com if the practice is a waiver provider).
05Claims submitted after February 1, 2027, from providers not active in PNM will be denied.
Original notice
[Ohio] Claims: Effective
providernews.anthem.com · Always check the source before changing claims.