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

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Anthem Blue Cross :

PW_A135539

ProviderAccess puts real-time eligibility, benefits and claims information at your fingertips.
New and improved online tools are just clicks away. For example, you can verify current and historical benefits for all members, including BlueCard members. ProviderAccess will minimize time spent on the telephone with Customer Service and allow more time for you to spend with your patients.
 
Features Include
Real-time patient eligibility, benefits, and accumulator data including current and historical coverage information for up to 50 members at a time.
Detailed co-insurance, co-payment and deductible information for ALL members, including BlueCard.
Improved Claim Status, details and payment information including submission of COB or authorization number, claim line level details/processing and real-time claim payment information.
Claim Submission for professional providers at NO charge.
Claim Status Reports including claims status by received, pending or processed and ability to drill-down to specific claim details.
Submission of Referral or Pre-authorization requests for Radiology procedures/services, including ability to check the real-time status of a request.
Ability to research medical policies and view operations manuals.
Online Provider Remittances - View, Save, Print Your Remittances Online Anytime - 24/7.
Clear Claim Connection is a tool for evaluating clinical coding information. It allows providers to view clinically based information along with documented source information for approximately 2 million edits also incorporating editing for some of our reimbursement policies.

 
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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.