Anthem Blue Cross and Blue Shield (Anthem) maintains a comprehensive Quality Management (QM) program to objectively monitor and systematically evaluate the care and service provided to members. The scope and content of the program reflects the demographic and epidemiological needs of the population served. Studies are planned across the continuum of care and service, with ongoing proactive evaluation and refinement of the program.
The goal of Anthem is continuous, measurable improvement in the delivery of and access to high quality healthcare. We follow regulatory and accrediting body requirements to monitor and evaluate the quality, safety and appropriateness of the medical and behavioral healthcare services offered in our health network. See Chapter 19 in our Provider Manual for detailed information regarding our quality improvement programs.
Anthem Quality Toolbox
We want to make sure you have all the tools you need to deliver quality care to your patients effectively, efficiently and in a timely manner. These key resources may assist you in providing cost-effective health care solutions:
- Prenatal Depression Screening and Follow-Up (PND-E) coding bulletin
- Important Anthem Blue Cross and Blue Shield (Anthem) contact information - January 2021
- Lead Screening in Children
- Medical record documentation standards
- Panel management and population-based care
- Access to Care Standards
- Quality Documentation Tool – Adult
- Advance Directives
- BH HEDIS® Quality Tool
- Provider Engagement CAHPS
- Caring for Diverse Populations
- Contact Card for Providers
- Gaps in Care – Frequently Asked Questions
- Strategies for Missed Appointments
- Quality Documentation Tool – Pediatric
- Right Choices Program
- HEDIS 101 Card
- Appropriate Treatment for Upper Respiratory Infection (URI)
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
Page Last Updated: 10/22/2021