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 are located on the Forms page of this site for easy access.
Anthem Blue Cross and Blue Shield Medicaid (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.
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 — eligibility and benefits inquiry, claims submission, claims status inquiry, and authorizations — can be accessed from your Availity account. You can find instructions for locating and using these tools on the Learn about Availity page.
Prior authorization resources
For information related to submitting a prior authorization request, please refer to your provider manual or visit the Prior Authorization Requirements page.
The Prior Authorization Lookup Tool Online can help you determine a code’s prior authorization requirements before a request is submitted.
The behavioral health provider network at Anthem includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance healthcare professionals.
Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.
Find a provider
To find a doctor, group or facility in our network, use the online provider search tool below.
Providers should immediately submit any changes to demographics, specialty, practice information, TIN, billing, office hours or appointment scheduling phone number directly to Anthem.
Need to report changes in practice status to Anthem?
Please complete the Provider Maintenance Form. If you need assistance, please visit the Contact Us page.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.