We are committed to supporting you in providing quality care and services to the members in our network. On these pages, you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to our members.
Provider forms are located in our online library for easy access.
Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) offers training and tutorials to support providers in continuing their education. Presentations, videos and other training documentation will be added as they become available.
Anthem provider manuals and guides provide key administrative information, including the quality improvement program, the Utilization Management program, quality standards for participation, claims and appeals, reimbursement and administration policies.
Anthem makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures and referrals to validate medical necessity.
Anthem’s behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance health care professionals. Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).