Provider resources overview
We are committed to supporting you in providing quality care and services to the members in our network. Here, 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
Provider forms are located in our online library for easy access.
Provider manuals and guides
Anthem provider manuals and guides provide key administrative information, including the quality improvement program, the utilization management program, quality standards for participation, claims appeals, reimbursement, and administration policies.
Training Academy
Anthem Blue Cross and Blue Shield (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.
Prior authorization requirements
To check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity Essentials or use our prior authorization lookup tool for outpatient services. Providers should use Availity Essentials to submit prior authorization requests for all medical (non-pharmacy) services.
Learn about Availity Essentials
Many of the tools you need — such as eligibility and benefits inquiry, and claims status inquiry – can now be accessed by logging into your account on the Availity Essentials Portal .
Electronic visit verification (EVV)
Electronic visit verification (EVV) is used by caregivers for some home and community-based services to document the time services begin and end. The Ohio Department of Medicaid provides an EVV system at no cost to all providers. For more information on electronic visit verification (EVV) please visit Ohio Department of Medicaid’s EVV resource page .
Electronic visit verification (EVV) resources
Related resources
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
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)