Provider manuals and guides

Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) is committed to supporting you in providing quality care and services to the members in our network. On this page, you will find information for assessing coverage options, guidelines for clinical Utilization Management (UM), practice policies and support for delivering benefits to our members.

Provider Manual

The Anthem provider manual provides key administrative information, including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies.

Medical Policies and Clinical UM Guidelines

Anthem uses nationally recognized, evidence-based Medical Policies and Clinical UM Guidelines.

Access a complete list of the Medical Policies and Clinical UM Guidelines .

Clinical Practice Guidelines

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.