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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.  
Our Behavioral Health Provider Relations team is available to assist contracted providers with questions about your fee schedule, contract (Agreement) language or requirements as specified in the Anthem Blue Cross Professional Manual. They can be reached by email BHNetworks@anthem.com.  
 
Announcements 
Behavioral Health Network Update (Newsletter) is a great way to stay current on Anthem Blue Cross news and information.  
 
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.

ABA – County Service Form

Provide the counties your practice 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.

Facility Service Inventory Form

Update contracted Facility service types i.e., substance abuse RTC for adults. Note: Not applicable to Professional providers.

Eating Disorder Facility Profile

Share eating disorder clinical program information with Anthem. Note: Not applicable to Professional providers.

 
Resources  
Request Participation to be a Network Provider
Behavioral Health Guide (Groups)

An interactive document created for our contracted behavioral health Commercial or ABA Group practices. It answers day-to-day questions, introduces a number of resources and self-service tools, and provides valuable information about Anthem Blue Cross.

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 © 2015 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.