Provider ServicesIf you have questions or need assistance, please contact your Provider Relations representative or contact Provider Services: Show
If you have questions: Phone:1-844-396-2330 Email:Fraud, Waste and Abuse ReferralsFraud, waste and abuse referrals can be made through the following avenues: Medicare/Medicaid Fraud Hotline:1-866-847-8247 Email usCompliance and Ethics Hotline:1-877-660-7890 Member Fraud, Waste and Abuse:1-800-600-4441 Receive email from AnthemAnthem is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email. Did you know that most questions and issues can be resolved by using the Anthem Blue Cross and Blue Shield Healthcare Solutions self-service tools? Please use Availity for inquiries like payment
disputes, provider data updates, claims status, member eligibility, etc. You can also live chat with an Anthem associate from within the Availity Portal. For other issues, you can message the Provider Experience team. Your Provider Experience representative will respond – usually within two business days. Provider tools & resources
Interested in becoming a provider in our network?We look forward to working with you to provide quality services to our members. Drugs that Require Prior Authorization Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. This approval process is called prior authorization. Drug list/Formulary inclusion does not infer a drug is a covered benefit. Please check your schedule of benefits for coverage information. Attention Medicare Members: The information on this page does not apply to members on Anthem’s Group Medicare Prescription plan with Senior Rx Plus. Please see the Group Medicare Drug Lists page or call Customer Service at the number on the back of your membership card for information on requirements which apply to the Group Medicare Prescription plans. Attention Prescribing Providers with members who are enrolled in an Anthem California plan: The Prescription Drug Prior Authorization Or Step Therapy Exception Request Form must be used for all members enrolled in a California plan, regardless of residence. We will be unable to review your request for authorization if it is not submitted on the Prescription Drug Prior Authorization Or Step Therapy Exception Request Form. The drug specific criteria and forms found within the (Searchable) lists on the Drug List Search tab are for informational purposes only to assist you in completing the Prescription Drug Prior Authorization Or Step Therapy Exception Request Form if they are helpful to you. Please fill out the Prescription Drug Prior Authorization Or Step Therapy Exception Request Form and fax it to (844) 474-3347. Select the Drug List Search tab to access up-to-date coverage information in your drug list, including – details about brands and generics, dosage/strength options, and information about prior authorization of your drug. Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require prior authorization. Please note:
Enhanced Care Management (ECM) under CalAIM is a care management benefit that is community-based and provides a whole person approach to care that addresses the clinical and nonclinical needs of members with the most complex medical and social needs. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. Community Supports under CalAIM are voluntary wrap-around services or settings available to members as a substitute for utilization of other services that focus on medical and/or needs that arise from social determinants of health. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. * Services may be listed as requiring precertification (prior authorization) that may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services. To determine coverage of a particular service or procedure for a specific member:
Customer Care CenterMonday to Friday, 7 a.m. to 7 p.m.Outside Los Angeles County: 1-800-407-4627 Inside Los Angeles County: 1-888-285-7801 After hours, call the 24/7 NurseLine to verify member eligibility:Phone: 1-800-224-0336 To request authorizations:
Provider tools & resources
Interested in becoming a provider in the Anthem network?We look forward to working with you to provide quality services to our members. How do I submit a prior authorization to availity?How to access and use Availity Authorizations:. Log in to Availity.. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*. Select Payer BCBSOK, then choose your organization.. Select a Request Type and start request.. Review and submit your request.. What is the provider phone number for Anthem BCBS of Ohio?By Phone: Call the number on the back of the member's ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative.
How do I contact Blue Cross Blue Shield of Georgia?Find information for Individuals & Families, Medicare or Employers. You can call 888.630.2583 to learn about your coverage options.
What is the fax number for Anthem Blue Cross of California?Phone: Call 1‑888‑831‑2246, option 3 and ask for a form to be faxed to you. Fax: Send your request to: 1-800-754-4708. Anthem Blue Cross is the trade name of Blue Cross of California.
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Anthem blue cross blue shield prior authorization phone number
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