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
Update to the Anthem Blue Cross Professional Manual mailed summer 2015
As you may be aware the Audit
section of our 2015 Professional Manual
contained language about Anthem’s Pre-Payment Review Program
. Anthem mailed an update to this section of the 2015 Professional Manual
which reflects an expansion of the Program. The expansion part of the program will be effective November 1, 2015
. “Click here
” for a description of the expanded program.
Contracted California providers who have questions about this expansion, may send email inquiries to:
Note: The above email addresses are reserved for Contracted providers. If you are not an Anthem participating provider, please call the phone number on the back of the member’s ID card for service. Thank you.
Online eligibility, benefits, claims status and authorization for services that require pre-authorization are available exclusively at www.availity.com
. Please register and begin to access this information using the Availity Web Portal
Request tax identification number, address, phone or fax, and open/closed practice changes.
Required when requesting a tax identification number change with a Practice Update.
Update self-reported areas of expertise.
Complete when pre-authorization is needed for outpatient professional services.
Pre-authorization is required for ABA assessment codes.
Complete for pre-authorization of outpatient ABA services.
Exchange behavioral health information with other healthcare providers.
Release of PHI and clinical information from Provider to Company.
Communicate information with other treating healthcare providers.
Submit for routine follow up and reconsideration of rejected or returned claims to avoid as duplicate.
Submit for reconsideration of a previous billing determination.
Update contracted Facility service types i.e., substance abuse RTC for adults. Note: Not applicable to Professional providers.
Share eating disorder clinical program information with Anthem. Note: Not applicable to Professional providers.
Resources and Support
Plans, Programs and Benefits
Policies, Guidelines and Tool Kits
Communications and Updates
California Behavioral Health Provider Relations: BHNetworks@anthem.com
or phone at 888-246-4893.