Anthem Blue Cross

Providers - California

Provider Resources Overview

We are committed to supporting you in providing quality care and services to the members in our network. Here you will find frequently used forms, PDFs, provider manuals and guides, policies, and support for delivering benefits to our members.

Provider Forms

Provider forms are located on the Forms page of this site for easy access.

Provider Education

Anthem Blue Cross (Anthem) offers training and tutorials to support providers in continuing their education through the Provider Training Academy. We will add presentations, videos and other training documentation as they become available. 

Providers can also find information related to long-term services and supports (LTSS), interpreter assistance, community-based adult services (CBAS) and other programs on this page.

Provider Manuals, Policies and Guidelines

Anthem provider manuals contain key administrative information, details regarding programs including the utilization management program and case management programs, quality standards for provider participation, guidelines for claims and appeals, and more.

Details regarding dental, vision and behavioral health services can also be found in the provider manuals.

Learn about Availity

Many of the tools you need — such as eligibility and benefits inquiry, claims submission, claims status inquiry and authorizations — can now be accessed by logging into your account on the Availity Portal.

Prior Authorization Resources

  • Anthem is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. ICR is a real-time prior authorization system through the Availity Portal where authorization requests can be completed, edited and submitted electronically. 
  • Alerts are sent to a provider’s email address when the status of the authorization changes or additional information is needed. 
  • You may also use the Availity Maternity Module to report a member’s pregnancy.
  • For more information related to submitting a prior authorization request, please refer to the Prior Authorization Requirements page.

The Precertification Lookup Tool Online can help you determine a code’s precertification (prior authorization) requirements before a request is submitted. 

Behavioral Health

The Behavioral Health provider network at Anthem includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance health care professionals. 

Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs. 

Provider Directory

Search for Medi-Cal Managed Care providers and Major Risk Medical Insurance Program providers via the Anthem website. Search by specialty, name, NPI or license number.

Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan): Provider Directories

2018 October Downloadable Provider Directory

 

 AEP 2019 October Downloadable Provider Directory

 

AEP 2019 November Addendum

2018 December Addendum

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.