Provider Manuals, Policies & Guidelines
Anthem Blue Cross and Blue Shield Medicaid (Anthem) is committed to supporting you in providing quality care and services to the members in our network. Here, you will find Anthem’s provider manuals, Guidelines for clinical Utilization Management (UM) and medical policies.
Provider manuals and quick reference guides
Anthem’s provider manuals provide key administrative information, details regarding programs that include the utilization management program and case management programs, quality standards for provider participation, guidelines for claims and appeals, and more.
Related resources
- May 2024 Clinical Utilization Management Guidelines
- HEDIS Well Child and Immunizations Bulletin 2024
- November 2023 Clinical Utilization Management Criteria
- HEDIS Measure Tip Sheet 2024 SNS-E
- HEDIS ECDS Coding Booklet 2024
- August 2023 Clinical Utilization Management Guidelines
- HEDIS Cat II Coding Bulletin 2024
- HEDIS ECDS Prenatal and Postpartum Care Coding Bulletin 2024
- HEDIS ECDS Prenatal and Postpartum Care Coding Bulletin 2023
- HEDIS Coding Booklet 2023
- HEDIS Desktop Reference Guide 2023
- Quality Measures Desktop Reference for Medicaid Providers
- Administrative Denial Notification
- HEDIS Well Child and Immunization Coding Bulletin 2022
- Provider Digital Engagement Supplement
Kentucky Cabinet for Health and Human Services: Department for Medicaid Services
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
DentaQuest is an independent company providing dental benefit management services on behalf of Anthem Blue Cross and Blue Shield Medicaid. EyeQuest is an independent company providing vision benefit management services on behalf of Anthem Blue Cross and Blue Shield Medicaid.