Provider demographics update

This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem).

 

Anthem partners with AIM Specialty Health_®* (AIM), a leading specialty benefits management company that provides services like radiology, cardiology, genetic testing, oncology, musculoskeletal, rehabilitation, sleep management and additional specialty areas (services vary by state). Partnerships like this require Anthem provider demographic information (group or practice name, additional providers added to the group/practice, location) is current and accurate to avoid provider and member abrasion.

 

In the event the provider's demographic information has not been updated in the Anthem system, the data will also be missing from the provider data that goes to AIM. Therefore, providers may not be able to locate the requested record in the AIM system. While the provider's information can be manually entered to build a case, the record will appear to be out-of-network, and the case will adjudicate accordingly.

 

Anthem provider data updates flow to AIM via the provider data extract, but the data flow does not work in the reverse. Anthem does not receive updated provider data from AIM. Therefore, it is important that providers make the following changes or updates with Anthem, not AIM:

• Group or practice name
• TIN
• NPI
• Address (add/remove location(s), corrections)
• Phone numbers
• Fax numbers
• Any additional demographic changes

 

What if I need assistance?

If you have questions about this communication or need assistance with any other item, contact your local Provider Relations representative or call Provider Services:

• Hoosier Healthwise: 1-866-408-6132
• Healthy Indiana Plan: 1-844-533-1995
• Hoosier Care Connect: 1-844-284-1798
• Medicare Advantage: Call the number on the back of the member ID card

510499MUPENMUB