Strategic Provider System to be implemented in August 2021

In July, Anthem advised of the delay in the implementation of our new data management system called Strategic Provider System (SPS), which was first announced in the June issue of Provider News. We are pleased to advise that SPS will now be implemented in August, and will replace our legacy internal provider data management system for Maine providers. This investment in advanced technology will significantly improve provider data accuracy and transparency, enhancing the overall provider experience. New system features strengthen our ability to match submitted claims for more accurate pricing and processing. 

 

System upgrades special notice  

We will be implementing SPS upgrades from August 6 through August 12. Provider demographic updates submitted during this time will be processed after August 12.  We appreciate your patience as we upgrade our systems. 

 

Next steps: New Provider Data Maintenance coming soon 

Beginning in September 2021, the second phase of our improvement will be integration with Availity’s Provider Data Management (PDM) functionality, which will roll out in phases. Through this tool, providers can view, maintain, update, and attest provider demographic information is accurate for Anthem (and other health plans) in one easy-to-use portal. This service will replace our Provider Maintenance Form in the coming months. The PDM service also features a simplified quick verification process, which enables providers to complete the required verifications online – eliminating the need to fax or email or use separate online forms.   

 

Get ready for the change today 

If your organization is not already registered on Availity portal, we strongly encourage you to get started right away. Your organization’s designated administrator can go to the Availity portal to register and to find other helpful information about using Availity. Availity is Anthem’s secure provider portal platform where providers can enjoy the convenience of digital transactions including prior authorization submission, claims submission and benefit and eligibility look-up.  

 

Starting with claims submitted after August 12, Anthem will deny claims submitted without a billing national provider identifier (NPI). Submitting claims with complete and correct data is critical to help ensure we are able to process your claims efficiently and accurately. Please submit your full address including your line 2 address (suite #, unit etc.) when applicable. All data fields on claims are used when building your claim record. Review your billing practices carefully to ensure provider tax identification number (TIN), billing national provider identifier (NPI), taxonomy code, and servicing/rendering provider information (if applicable) are submitted in the appropriate fields.  

 

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