Verifying and updating your provider information
Additionally, Anthem Blue Cross and Blue Shield (Anthem) is required by Centers for Medicare & 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.
Please make any necessary corrections using the Provider Maintenance Form. The Provider Maintenance Form (PMF) is available online at anthem.com. Select Providers │ under Provider Resources heading, select Provider Maintenance Form (Note: select Nevada, if you haven’t done so already). The PMF can also be found on the Availity Portal │ Payer Spaces │ Anthem Blue Cross and Blue Shield icon │Resources │ Provider Maintenance Form.
December 2019 Anthem Provider News and Important Updates - Nevada