Provider data 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 for radiology, cardiology, genetic testing, oncology, musculoskeletal, rehabilitation, sleep management, and additional specialty areas. Partnerships like this require that Anthem’s provider demographic information (group or practice name, additional providers added to the group/practice, location) is current and accurate to eliminate provider and member abrasion.

 

In the event the provider's demographic information has not been updated in Anthem’s 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 AIM’s 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 back to Anthem. 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 changes

 

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

• Medicaid: 1-855-558-1443
• Medicare Advantage: Call the number on the back of members’ ID cards

 

* AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield.

 

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