Maintaining accurate provider information is critically important to ensure our members have timely and accurate access to care.

 

Additionally, Anthem Blue Cross and Blue Shield (Anthem) is required by Centers for Medicare and Medicaid Services (CMS) to include accurate information in provider directories for certain key provider data elements. For Anthem to remain compliant with federal and state requirements, changes must be communicated 30 days in advance of a change or as soon as possible.

 

Key data elements

 

The data elements required by CMS and crucial for member access to care are:

  • Physician name
  • Location (such as address, suite if appropriate, city/state, zip code)
  • Phone number
  • Accepting new patient status
  • Hospital affiliations
  • Medical group affiliations

 

Anthem is also encouraged (and in some cases required by regulatory/accrediting entities) to include accurate information for the following provider data elements:

  • Physician gender
  • Languages spoken
  • Office hours
  • Provider specialty/specialties
  • Physical disabilities accommodations
  • Indian Health Service status
  • Licensing information (i.e., medical license number, license state, National Provider Identifier - NPI)
  • Email and website address

 

How to verify and update your information

 

To verify information, go to anthem.com and select “Providers,” and then under “Provider Resources” select “Find a Doctor” tool. Use “Search as a Guest” at the bottom.  If your information is not correct, please update the information as soon as possible.

 

To update information, go to anthem.com and select “Providers,” and then under “Provider Resources” select “Provider Maintenance” and follow the online prompts.

 



Featured In:
December 2019 Anthem Provider News - Kentucky