Claims Submission
Filing your claims should be simple. That’s why Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. You can use Availity to submit and check the status of all your claims and much more.
Don't have an Availity account? You can register here.
Providers, improve your prior authorization and claims submission process. Our new online Clinical Documentation Lookup Tool (CDLT) gives real-time access to the highly recommended medical documents needed with submission.
Effective January 01, 2022
Many Group Retiree Solutions (GRS) plans now include the requirement that all hearing aids be supplied by Hearing Care Solutions (HCS).
If you are not an HCS provider and are going to fit a patient for a hearing aid, first verify the member’s out-of-network benefits and then follow the protocol outlined in the following document:
More Resources
EDI
Electronic Data Interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims.
Provider Appeals
You have the right to request an appeal of a coverage decisions. You may request this appeal on your own behalf or on behalf of a covered Individual.
Networks at a Glance
There are many plans in the NV Market. This reference guide allows providers to find more information about networks, plans, and alpha prefixes.
Prefix Reference List
Member ID’s start with an alpha prefix. This prefix determines contact information for the member’s plan. This reference list allows providers to identify member plans, plan types, provider service numbers, and mailing addresses.
How to Confirm Your Participation Status with Member Plans
There are many plans in the Nevada market. This guide helps you understand how to use your Provider Agreement and the directory to confirm your participation with member plans.
