Anthem billing and credentialing
Billing and credentialing for Anthem Blue Cross and Blue Shield plans, part of Elevance Health.
Working with Anthem
Anthem is the Blue Cross Blue Shield licensee in several states and is part of Elevance Health, which also runs Medicaid and Medicare plans under the Wellpoint brand in many states.
Plan types we bill:
- Commercial plans
- Medicare Advantage
- Medicaid in some states
Credentialing and enrollment
Credentialing uses your CAQH ProView profile, so it must be complete, attested within the last 120 days and authorized for the payer before the application is reviewed.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Anthem uses Availity for eligibility, claims, authorizations and remittances. Anthem plans also process out-of-area BlueCard claims for members of other Blue plans.
Denials we prevent with Anthem
- Provider not credentialed or not linked to the group TIN
- Missing prior authorization for services on the payer’s list
- Eligibility or coordination of benefits issues
- Coding edits and bundling under payer policy
- Claims filed after the contract’s filing limit
Questions about Anthem
Is Anthem the same as Blue Cross Blue Shield?
Anthem is one of the independent Blue Cross Blue Shield companies, operating in specific states.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Anthem claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.