In July 2021, Anthem will replace its legacy internal provider data management system for Virginia contracted providers.  This investment in advanced technology will significantly improve provider data accuracy and transparency, enhancing the overall provider experience.  New system features strengthen Anthem’s ability to match submitted claims for more accurate pricing and processing.


System upgrades special notice


Anthem will implement system upgrades beginning July 10 through July 14.  Provider updates submitted during this time will be processed after July 14.  We appreciate your patience as we upgrade our systems.


Next steps: New Provider Data Maintenance coming soon


Beginning in August, 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 Anthem’s 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 Availity.com to register and to find other helpful information about using Availity.  Availity is Anthem’s secure provider portal platform where providers you can enjoy the convenience of digital transactions including prior authorization submission, claims submission and benefit and eligibility look-up.


Reminder about critical billing requirements


Claims submitted without a billing National Provider Identifier (NPI) will be denied. Submitting claims with complete and correct data is critical to ensure Anthem is able to process your claims efficiently and accurately. 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 provider information (if applicable) are submitted in the appropriate fields.


1174-0621-PN-VA



Featured In:
June 2021 Anthem Provider News - Virginia