Claims Overview

Filing your claims should be simple. That’s why Anthem Blue Cross and Blue Shield Medicaid (Anthem) uses Availity, a secure and full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. You can use Availity to submit and check the status of all your claims and much more at www.availity.com .

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Related resources

EDI

Electronic data interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims. 

Availity serves as the EDI partner for all electronic data and transactions from Anthem.

Access EDI

Provider disputes

You have the right to request an appeal of a claim decision. You may request this appeal on your own behalf or on behalf of a covered individual.

Reimbursement policies

Policies outlining the basic terms for reimbursement of services covered under our members’ benefits plans. Also, helpful definitions for terms associated with reimbursement policies.

Claims information in the provider manual

You can find claims contact information, pharmacy claims instructions, guidelines for claims submission and more in the provider manual.

Forms

Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.

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.