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

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.

Provider tools & resources

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We look forward to working with you to provide quality services to our members.