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Anthem has many plans for members. As a provider, it is important to confirm you participate with a member’s plan before rendering services. To confirm if you participate or are in network with a member’s plan, you should review your Provider Agreement and the online directory, Find Care:
 
  • Select the Find Care link at the top right of the page.
  • Search by entering the Member ID or search as a guest:
    • Use Member ID for Basic Search: Search by entering the Member’s ID number (including the three-character prefix), or simply enter the three-character prefix.
    • Basic search as a guest: Search by selecting a plan and network. Note: The member’s network name should be on the lower right corner of the front of the member’s ID card.
       
  • If you are not sure which plan or network, search using PPO.
  • Enter a city, county, or ZIP code and search by doctor name, group name, and more.
  • From the provider's profile page, select the Insurance tab on the top right menu to see all the plans the provider participates with.
  • Be sure to confirm the address information.

Providers contracted with Anthem Blue Cross and Blue Shield (Anthem) should utilize Availity’s Provider Demographic Management (PDM) application hosted on www.Availity.com to request changes to existing practice information.

Log into www.Availity.com > Select My Providers > Select Provider Data Management > Review and update your data.

  • These changes will be made across all lines of business you participate with.
  • Please allow 30 days for processing.
  • Need help navigating PDM? Log into Availity and use the Help & Training tool in the upper right-hand corner on the Availity homepage.

For larger organizations: Roster Automation is a new system upgrade that will read a standardized form, identify necessary changes, update the demographic system, and allow providers to submit changes in bulk.

Roster Automation Rules of Engagement

Roster Automation Standard Template

If your organization is not currently registered with Availity, the person(s) designated as your administrator(s) should go to www.Availity.com and select register in the upper right-hand corner of the webpage in order to obtain an Availity account. You may also navigate directly to Availity’s registration website by clicking here: Availity registration

If you are an existing contracted group and wish to add a provider, or if you are a non-contracted provider and would like to join Anthem’s network: Begin Application

To learn more about the application process before you begin, visit the Getting Started with Anthem page.

Ready to join our network? Once you select your state and provider type on the enrollment page, you will be redirected to the secure Availity Essentials* to finish the application process.

*Behavioral Health Providers

The behavioral health networks at Anthem have merged with Carelon BH. If you are currently not participating with us, please read and follow the instructions below to apply.

If you are a solo practitioner or provider group who only provides behavioral health services, please go Carelon BH https://www.carelonbehavioralhealth.com/providers/join-our-network.

If you are part of an existing or multi-specialty provider group who provides multiple health services and specialties (includes behavioral health and non-behavioral health specialties), please go Availity at https://availity.com and complete the provider enrollment application.

Applications are typically completed within 30 days of the submission date.

Application status is available on the same screen you submitted your application within Availity.*

Log into www.Availity.com > Select Payer Spaces > Select Provider Enrollment > Review the status of your submitted applications.

Don’t have access to Availity or still have questions? Contact Provider Services: Call 800-676-BLUE (2583) to confirm participation status.

*Behavioral Health providers who submitted applications with Carelon BH must work with Carelon BH directly.

Did you know that most questions and issues can be resolved instantly by using Anthem’s self-service tools? Use www.Availity.com to check claim status, dispute claims, maintain provider data and so much more!

Using www.Availity.com participating and non-participating providers can:

  • View claim status
  • Dispute claims
  • View remittance advice
  • Verify if prior authorization is needed
  • Submit prior authorization requests
  • Submit referrals
  • Check status of referrals
  • Verify member eligibility and benefits information

If you don’t have an Availity account, you can register for access and view the on demand and/or instructor led trainings to become familiar with Availity’s robust features. Availity is the preferred method for contacting Anthem.

Availity chat with payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. Log in to the Availity Essentials and select Anthem from the payer spaces drop-down menu. Then, select Chat with Payer and complete the pre-chat form to start your chat.

Provider Services: Call the number on the back of the member’s ID card or call 800-676-BLUE (2583) to speak to a Provider Service representative.

We understand that providing the information needed to process a claim can cause payment delays, and the manual methods associated with mailing letters and returning information non-digitally is costly and inefficient.

We’re changing that by implementing a new process: Digital Request for Additional Information (Digital RFAI), and we’re inviting you to participate.

Digital requests for additional information are 50% faster than returning documentation any other way — making it the most efficient way to receive and return information — resulting in faster claim payments.

Sign up today!

If you’re not already using the Digital RFAI process and want to take advantage of faster claims processing, participation is easy.

1.Registration        The organization’s Availity administrator will register for Medical Attachments, which enables care provider organizations to receive notices from the payer and submit requested documents digitally. All billing NPIs/TINs must be registered.
2.User Roles The Availity administrator will be required to update or add new users with these specific role assignments through Availity:
  • Claims Status
  • Medical Attachments
Enable users to view the Availity Attachment Dashboard.
3.Ready to go! After the registration and user roles are completed on Availity, the Digital RFAI process is ready. Requests will automatically appear on the Attachments Dashboard each morning (when documents are needed).

Additional support

You, your organization’s Availity administrator, or other members of your team may need additional support – and we’re to help:

  • For Availity Administrators: Take this training to ensure your NPIs are registered properly.
  • For those sending attachments: Take this user training to learn about accessing notifications, sorting and filtering, and other enhancements that improve your experience.

Get answers instantly!

  • Self-Service
    • Did you know that most questions and issues can be resolved by using Anthem’s self-service tools? Use Availity.com to check claim status, dispute claims, maintain provider data and so much more!
  • Contact Provider Services
    • Our Provider Service team is ready to help you now! You can contact Provider Services using the method that works best for you.
      • Call 800-676-BLUE (2583)
      • Log into Availity.com and chat with a live agent or send a secure message.

Non-participating providers: Call the number on the back of the member’s ID card or call 800-676-BLUE (2583) to reach Provider Services. You can also use chat or secure messaging directly in Availity.

Participating providers only: If you have tried the resources listed on this page and still need assistance, send us a message and you will receive a response within 2 business days.

Availity, LLC is an independent company providing administrative support services on behalf of the health plan. Carelon Medical Benefits Management is an independent company providing some utilization review services on behalf of the health plan.