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_M010396
At Anthem, we make provider service our highest priority. Our mission is to improve the lives of the people we serve and the health of our communities.
If you cannot find what you are looking for on our Online Provider Services Web site, use this guide to determine the appropriate provider service center for your inquiries.
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Provider Call Center
(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) 332-6558
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YGA, YGC, YGF, YGG, YGK, YGM, YGX
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New England Health Plan (NEHP) and *Empire HMO plans
Claim inquires
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8:00 a.m. - 5:00 p.m.
Monday - Friday
(IVR available 24/7)
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(800) 238-2465
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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 Maine 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 Maine
(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) 832-6011
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XVA, XVB, XVG, XVH, XVP
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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) 417-8489
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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 PM
(IVR available 24/7)
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(800) 852-3316
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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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American Imaging Management prior authorization and pre-certification for non-emergency advanced imaging
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(866) 714-1107
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Anthem Online Provider Services (AOPS)
 | Online Provider Services password changes or requests |
| Online Provider Services navigation questions |
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(866) 755-2680
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| Enrollment and testing for EDI services |
| Transmission or connection support for EDI services |
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(800) 334-8262
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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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