Claims overview

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

Don’t have an Availity account?

More 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.

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

These are policies outlining the basic terms for reimbursement of services covered under our members’ benefits plans. Also, we include definitions for terms used in the policies and disclaimer for the policies’ use.

Enrollment and Revalidation Requirements for Anthem Medicaid Participation

To bill for services rendered or to order, prescribe and refer services to Nevada Medicaid recipients you must enroll as a Nevada Medicaid provider and revalidate enrollment timely. This is also true to bill for services rendered or to order, prescribe and refer services to Nevada Medicaid recipients enrolled through a Managed Care Organization (MCO), such as Anthem.

Provider tools & resources

Interested in becoming a provider in our network?

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