Welcome, providers!

At Anthem Blue Cross and Blue Shield (Anthem), we combine national expertise with an experienced local staff to operate community-based healthcare plans. Anthem is dedicated to offering real solutions that improve healthcare access and quality care for our members.

On this site, you’ll find resources that help healthcare professionals do what they do best — care for our members.

Provider Revalidations

For questions or concerns regarding the Ohio Department of Medicaid (ODM) provider network management portal (PNM), please contact ODM's integrated helpdesk at 800-686-1516.

Ensure our members are equipped to renew their Medicaid benefits

Help our members prepare to renew their Medicaid healthcare coverage and benefits by educating them on what documents are needed to ensure their renewal form is completed accurately. Members can submit their renewal form via web (preferred), phone, fax, mail, or in person.

For questions about eligibility, benefits, authorizations, claims status, and more, log in to Availity Essentials* and select Chat with Payer. For additional support, please use the following resources or contact us if more clarification is needed.

Availity Essentials access

The Availity Essentials portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. Register and log in for access to help and training materials. Registration is free!

 

Learning opportunities

Find learning opportunities to assist with administering your patient’s health plan using Availity’s multi payer features and our payer spaces applications. Use our library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.

Launch Provider Learning Hub Now

Receive email from Anthem

Anthem sends provider bulletins, policy change notifications, prior authorization update information, educational opportunities, and more to providers via email.

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Provider manual

The Anthem provider manual will provide key administrative information, including the quality improvement program, the utilization management program, quality standards, claims appeals, and reimbursement and administration policy information.

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Provider news

Provider News is your source for important news and announcements, including policy updates, prior authorization changes, new product and program offerings, and more.

Find providers in our network

View our online provider directory.

Featured resources

Pharmacy information

Pharmacy benefits for enrolled members are managed through the Ohio Department of Medicaid. The Ohio Department of Medicaid (ODM) has contracted with a single pharmacy benefit manager (SPBM) to improve the administration of pharmacy benefits for managed care recipients and ensure transparency, accountability, and integrity to better serve Ohio Medicaid members and their healthcare providers.

Maternal child program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program. The New Baby, New Life program is a comprehensive, proactive care management and care coordination program for all expectant mothers and their newborns.

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Behavioral health

We work collaboratively with hospitals, group practices and independent behavioral healthcare providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

Provider tools & resources

Join our network

We’re glad you’re interested in joining the Anthem network. We have a diverse network of exceptional healthcare professionals who ensure our members have uninterrupted access to the support they need.