MyAnthem
Not registered? Sign up to enjoy secure access to personalized information.
Register Now

Access personalized services and information.

Login
Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan members.

Enter
Find a Doctor
Search our online provider directory when you need a doctor, hospital or other health care provider.

Enter

Provider Home

PW_AD080079
Important Updates:  
Health Care Reform Updates and Notifications 
Learn about the many ways health care reform will impact providers. New information is added regularly.  
Anthem now available on Availity 
Sign up for Availity to access information from multiple payers, including Anthem Blue Cross and Blue Shield. With a single sign-on, you are able to check eligibility, claims, and more. It’s easy to register: Go to www.availity.com or contact your local eBusiness consultant at central.eprovider.rep@anthem.com 
Provider Education Seminars  
Network Update  
 
Network Rapid Updates: (past issues | sign–up) 
Anthem Launches 5010 and ICD-10 Webpage – August 6, 2010
Precertification of Cardiac Imaging Services (SE, TTE, TEE) – July 16, 2010
Medical Policy Update – July 12, 2010
Corrections Underway for Some BlueCard® Paper Remittances – July 12, 2010
Medical Claims with Expired Member ID Prefixes Will Reject – July 1, 2010
Expanded Precertification Requirements Become Effective July 6, 2010
 
Lumenos Consumer Driven Health Plans
Anthem Blue Cross and Blue Shield is now offering new Lumenos plans designed to help consumers make better personal choices about their health care dollars. 
 
eSolutions for Providers
 
Anthem Mobile Provider Finder
 
We’re Changing Member ID Numbers to Help Guard Against Identity Theft
To help protect our members from identity theft, Anthem is removing Social Security Numbers from member ID cards and Explanation of Benefits (EOBs) statements. 
 
Anthem Customized Claim Edits
Providers have asked for access to Anthem’s “customized” edits and now they will be made available online. 
 
Anthem Medical Policies and Clinical UM Guidelines
You can get Anthem Medical Policies and Clinical UM Guidelines any time you need them with a click of your mouse. 
 
Behavioral Health Medical Necessity Criteria
 
Practice Guidelines
View and print our Physician Guidelines.  
 
Precertification Guidelines
Precertification is the determination that selected inpatient and outpatient medical services, including surgeries, major diagnostic procedures and referrals meet criteria fro medical necessity under the member’s benefits contract. For details on Pharmacy Precertification Requirements, please visit our pharmacy website. 
 
Take the NPI Provider Survery
We are currently in the process of finalizing our implementation plan for the National Provider Identifier. We have linked a survey that will help us better understand the awareness of the NPI in the provider community. The information gathered will assist us in smoothly transitioning your current provider ID to the NPI. Please take a moment to complete the NPI survey 
 
Cultural and Linguistic Provider Resources
The latest tools, training, resources and information to help bridge cultural and linguistic barriers to care.  
 
Electronic Data Interchange (EDI)
Access the latest news, updates, and learn how EDI can be used to submit claims and other transactions, saving you time and money. 
 
Web-Based Claims Submission & Electronic Options
MD On-Line, Inc., a leading national clearinghouse, to offer professional providers the ability to exchange secure HIPAA-compliant transactions through a web-based suite of services – 60 Day Free Trial. 
 
Dental Providers  
We understand your time is valuable, so we developed this site to help you access the information you need when you need it. Here, you'll find a one-stop-shop for all things dental. 
©2005-2009 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri: RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ® ANTHEM is a registered trademark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Serving residents and businesses in Indiana, Kentucky, Missouri (excluding 30 counties in the Kansas City area), Ohio, Wisconsin, Colorado, Nevada, Connecticut, Maine, New Hampshire and Virginia (excluding the city of Fairfax, the town of Vienna and the area east of State Route 123). Use of the Anthem Web sites constitutes your agreement with our Terms of Use