As of October 1, 2018 you should be utilizing the new Anthem Blue Cross (Anthem) prior authorization form for Medi‑Cal Managed Care and L.A. Care members.


You will be happy to know that we have added additional requirements to make it easier for you when submitting prior authorization requests. This will help in a faster turn-around-time and will help us in servicing you better.


Additional requirements added include:

  • A checkbox for the provider to choose between an initial request and a continuation.
  • Fields for both physicians and facilities: servicing physician/facility name, tax ID/Medicare number, NPI, address, phone number and fax number.


Acquire an Anthem prior authorization form via web, phone or fax:

  • Web: Access the form directly at Provider Support > Forms > Prior Authorization Forms > Request for Preservice Review.
  • Phone: Call 1‑888‑831‑2246, option 3 and ask for a form to be faxed to you.
  • Fax: Send your request to: 1-800-754-4708.

Featured In:
December 2018 Anthem Blue Cross Provider Newsletter - California