Anthem Online Provider Services
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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan and BlueCard Out-of-Area members.
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Find a Doctor
Search our online provider directory when you need a doctor, hospital or other health care provider.
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Contact Us
PW_014969
Below is a list of telephone numbers for our various provider call centers as well as other commonly used telephone and fax numbers. If you cannot find what you are looking for on our Anthem Online Provider Services website, use this guide to determine the appropriate provider service center for your inquiries.
In order to help ensure that your inquiries are tracked and responded to timely, all inquires must be made to Provider Service or through Anthem Online Provider Services. If you wish to speak with someone directly please contact the appropriate Provider Service number listed below.
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Provider Service
(local Anthem plans)
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8:00 a.m. - 5:00 p.m., Monday - Friday
(IVR available 24/7)
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(800)832-6011
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XVA, XVB, XVG, XVH, XVP
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New England Health Plan (NEHP) and *Empire HMO plans
Claim inquiries
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8:00 a.m. - 5:00 p.m., Monday - Friday
(IVR available 24/7)
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(888)567-1834
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CTN, CTP, EHF, EHG, EHH, EHJ, MEN, MEP, MTN, MTP, NHN, NHP
*Empire prefixes - BJY, YLF, YLL, YLQ
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Eligibility and benefits
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8:00 a.m. - 5:00 p.m., Monday - Friday
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(800)676-BLUE (2583)
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Tri-state
Anthem plans in Connecticut, Maine and New Hampshire utilize the same membership and claims systems, therefore, inquiries for Connecticut and New Hampshire members are considered local or ‘tri-state’ inquiries. Please contact the following numbers for the specified prefixes.
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Anthem Connecticut (tri-state)
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XG**, ATM, CKC, HJB, INF, LBG, LGI, LOS, MCK, MGG, OTW, PHT, TLD, TUV, URI, URR
**third alpha character will vary
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Professional
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8:00 a.m. - 5:00 p.m.
Monday - Friday
(IVR available 24/7)
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(800)922-3242
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Institutional
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8:00 a.m. - 5:00 p.m.
Monday - Friday
(IVR available 24/7)
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(800)345-2227
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Anthem New Hampshire (tri-state)
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8:00 a.m. - 5:00 p.m.
Monday – Friday
(IVR available 24/7)
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(800)332-6558
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YGA, YGC, YGF, YGG, YGK, YGM
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BlueCard® Service Center
Claim inquiries
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8:30 a.m. - 5:00 p.m., Monday - Friday
(IVR available 24/7)
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(877)795-1881
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All prefixes not listed elsewhere in this grid
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Eligibility and benefits
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8:00 a.m. - 5:00 p.m., Monday - Friday
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(800)676-BLUE (2583)
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Federal Employee Program® (FEP)
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Monday - Wednesday, Friday -
8:00 a.m. - 5:30 p.m. Thursday - 9:00 a.m. - 5:30 p.m.
(IVR available 24/7)
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(800)722-0203
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R (followed by 8 digits)
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Medicare Advantage
SmartValue
(private fee for service (PFFS)) plans
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8:00 a.m. - 8:00 p.m.
Monday - Friday
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(866)364-2374
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JQQ, JWI, VZI, XDV***, XFQ, XGA, XKB, XPI, XTI,
XVD, YFE, YGB, YLI, YRF, YRI, YTL
***Note: Prefix XDV was replaced as of Jan 1, 2008.
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Medicare Advantage
other HMO and PPO plans throughout the United States
#Medicare Advantage (MSA) plans - no longer offered
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varies
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see member’s ID card
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JQV#, JWJ#, VXA#, VZJ#, XDG, XDK, XDT, XFU, XFV#, XGD#, XKD#, XPJ#, XTJ#, XVE#, YFQ#, YGD#, YLO#, YLQ, YLR, YLV, YRA, YRE, YRJ#, YTN#
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MediBlueSM HMO
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8:00 a.m. - 8:00 p.m.
Monday - Friday
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(866)673-4157
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XGH
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Taft-Hartley / Teamsters
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8:00 a.m. - 5:00 p.m. Monday - Friday
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(888)287-0032
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CCU, ELH, IUP, NEF, NEH, PSH, PTH, SVL, TLH, TSJ, NIW, CWV, IRU, IUB, EWU
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 | Online Provider Services (AOPS) (866) 755-2680 |
 | Anthem Online Provider Services password changes or requests |
 | Anthem Online Provider Services navigation questions |
 | Data Interchange (EDI) (800) 334-8262 or (207) 822-8385 |
 | Enrollment and testing for EDI services |
 | Transmission or connection support for EDI services |
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Credentialing/recredentialing for medical professionals
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(800) 832-6011
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Status of application for participation in managed care network
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(800) 832-6011
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American Imaging Management prior authorization and pre-certification for non-emergency advanced imaging services
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(866) 714-1107
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Care Management
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Case Management
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(800) 231-2398
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BlueCard
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(800) 676-BLUE (2583) (ask to be transferred to utilization review)
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Precertification (acute inpatient admissions, concurrent review and outpatient cardiac rehabilitation)
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(800) 860-2156
Fax: (800) 732-8318
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Case management
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(800) 711-2225 or fax to (800) 732-8318
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Transplant prior approval (except bone marrow)
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(800) 824-0581 (option 2)
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Bone marrow transplant
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(800) 225-2268
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Anthem Behavioral Health (Anthem Blue Cross and Blue Shield and FEP members)
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(800) 755-0851
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Behavioral HealthCare Program (MaineHealth enrollees)
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(800) 538-9698
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Anthem is committed to protecting the integrity of the healthcare system we serve through the detection and prosecution of those parties responsible for fraud against Anthem Inc. and its affiliated companies.
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