Care management
Anthem Blue Cross and Blue Shield (Anthem) care managers help make healthcare easier and less overwhelming for our members. They work with our members to help them understand the types of services we offer to them and how to participate in their own care.
Care management services
Your patients may already be working with one of our care managers. If not, or if they need help contacting their care manager, please have them call Member Services .
Our care managers may call our members if:
- They or you, their healthcare provider, thinks care management might help the member
- They’ve just gotten out of the hospital and need help with follow-up visits to other doctors
- They’re going to the emergency room (ER) often for non-urgent care that could be handled by you, their healthcare provider
- They call 24/7 Nursline and need more follow-up for ongoing care
- They have serious physical problems and need more help managing their health
- They have behavioral health problems and need more help working with all of their doctors
Care managers can also help with:
- Setting up healthcare services for the member
- Getting referrals and prior authorizations
- Checking a member’s plan of care
From time to time, members may have questions about calls they receive from one of our care managers. When we call, a nurse or social worker will:
- Always identify themselves with their name, title, and position with Anthem Blue Cross and Blue Shield
- Tell the member about the services we offer
- Talk to the member about their health and how they’re handling different parts of their life
Provider tools & resources
- Log in to Availity Essentials
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Provider Search Tool
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)