Policies, guidelines and manuals
Locate information for assessing coverage options, guidelines for clinical Utilization Management (UM), clinical practice guidelines (CPGs) and support for delivering benefits to our members.
Provider manual
The Anthem provider manual provides key administrative information, including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies.
Medical Policies and Clinical UM Guidelines
Anthem uses nationally recognized, evidence-based Medical Policies and Clinical UM Guidelines.
Access a complete list of the Medical Policies and Clinical UM Guidelines.
Clinical Practice Guidelines
February 2025 Clinical Utilization Management Guidelines
November 2024 Clinical Utilization Management Guidelines
August 2024 Clinical Utilization Management Guidelines
May 2024 Clinical Utilization Management Guidelines
February 2024 Clinical Utilization Management Guidelines
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