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Anthem Blue Cross : Behavioral Health Provider Resources

Behavioral Health Provider Resources

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Our extensive provider network includes psychiatrists, psychologists, social workers, psychiatric mental health nurse practitioners, psychiatric nurses, marriage and family therapists and professional clinical counselors. The facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs. 
Member benefits will vary based on Plan and Product, therefore it’s important that eligibility, benefits and authorization requirements are verified before starting treatment. 
 
Announcements 
On May 11, 2015 a summary notice was mailed regarding updated guidelines and polices effective for service dates on and after August 15, 2015. The effective date complies with a 90-day notification requirement. It is important that you view the Anthem Blue Cross Medical Policies and Clinical UM Guidelines in their entirety for other updates. 
Our Behavioral Health Provider Relations team can assist you with questions about your fee schedule, contract (Agreement) language or requirements as specified in the Anthem Blue Cross Professional Provider Manual. They can be reached by email BHNetworks@anthem.com.  
For 1099 Tax Forms contact our Tax Department by email: 1099dept@anthem.com or
phone: 888-246-4893.  
Based on Network need and on-going mandates, until further notice, Anthem is only accepting requests from practitioners who provide medication management services, including psychiatric mental health nurse practitioners.  
Online eligibility, benefits and claims status will now be available exclusively at www.availity.com. Please register and begin to access this information using the Availity Web Portal.  
 
Forms 
Practice Update

Request tax identification number, address, phone or fax, and open/closed practice changes.

TaxFormW-9

Required when requesting a tax identification number change with a Practice Update.

Practice Profile

Update self-reported areas of expertise.

Pre-authorization Request

Complete when pre-authorization is needed for outpatient professional services.

ABA - Adaptive Behavior Assessment Request Form

Pre-authorization is required for ABA assessment codes.

ABA - Treatment Plan Request Form Autism Spectrum Disorders

Complete for pre-authorization of outpatient ABA services.

Behavioral Health Consent to Exchange

Exchange behavioral health information with other healthcare providers.

Individual Authorization Form

Release of PHI and clinical information from Provider to Company.

Coordination of Care Form and Letter Templates

Communicate information with other treating healthcare providers.

Claims Re-Process/Inquiry Request

Submit for routine follow up and reconsideration of rejected or returned claims to avoid as duplicate.

Provider Dispute Request Form

Submit for reconsideration of a previous billing determination.

 
Resources and Support 
Become A Network Provider
Anthem BlueCross Department Contacts Listing
Provider Network Education
Electronic Data Interchange(EDI)
Availity Web Portal
 
Plans, Programs and Benefits 
Applied Behavior Analysis(ABA)
Blue Card Program Provider Manual
Behavioral Health Medi-Cal
 
Policies, Guidelines and Tool Kits 
Behavioral Health Clinical Practice Guidelines
Behavioral Health Clinical UM Guidelines
Behavioral Health Follow Up Program (FUAH)
Provider Tool Kits
 
Communications and Updates  
Network Update (Newsletter)
Network eUPDATEs
Health Insurance Exchange Information
Health Care Reform Updates and Notifications
ICD-10 Updates
 
Contact Us 
California Behavioral Health Provider Relations: BHNetworks@anthem.com 
TaxForm1099: 1099dept@anthem.com or phone at 888-246-4893.  

® Anthem is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association © 2011 Anthem Blue Cross.

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.