Anthem Blue Cross Blue Shield of Ohio
Ohio • Medicare Advantage, HMO, Traditional Indemnity
This prefix includes Medicare Advantage coverage. MA plans follow CMS guidelines for timely filing (365 days from date of service), which may differ from the commercial plan's deadline. The payer ID for Medicare Advantage claims may differ from the standard commercial payer ID. Verify before submitting.
Under this HMO prefix, the member's coverage is limited to the plan's provider network. Care is coordinated through a primary care physician. Specialist visits require a referral from the PCP. When billing, confirm that the referring provider and the referral authorization number are included on the claim.
This is a traditional indemnity prefix. Unlike managed care plans (HMO, PPO, EPO), indemnity plans do not use provider networks. There are no referral requirements and no restrictions on which providers the member can see. Submit claims to the payer listed above for reimbursement at the plan's allowed rate.
Independent licensee providing commercial, Medicare and Medicaid plans to Ohio members.