Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. An Independent Licensee of the Blue Cross and Blue Shield Association, Summary of Benefits & Coverage Information, Sleep Testing and Therapy & Advanced Imaging, Confirm your specific treatment plan and medical necessity given your diagnosis, Determine if services are eligible for coverage, Assure your claims are processed accurately and timely, Save you from unnecessary medical expenses. Tagalog | The Internet Explorer 11 browser application will be retired and go out of support on June 15, 2022. Posted Jan. 11, 2021. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. In Indiana: Anthem Insurance Companies, Inc. The resources for our providers may differ between states. Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to offer health plans in all 75 counties of Arkansas. This tool does not reflect benefits coverage, Access eligibility and benefits information on the, Use the Prior Authorization Lookup Tool within Availity. Located in neighborhoods all over the country, CareMore Health Care Centers combine a variety of different specialty services under one roof. Get Started | PPO outpatient services do not require Pre-Service Review. Or if you are calling about a specific case, they will direct your call to the appropriate prior authorization staff. Your plan has a list of services that require prior authorization. Sign in to the appropriate website to complete your request. Also, specify any allergies and give the name and phone number of the patients authorized representative (if applicable). Prior authorization is required for surgical services only. | Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Sep 1, 2021 It looks like you're outside the United States. Medical Policy and Prior Authorization for Blue Plans. You further agree that ABCBS and its The owners or operators of any other websites (not ABCBS) are solely responsible for the content and operation Your contract lists covered services, like a wellness exam, immunization or a diagnostic test. Prior approval for requested services - Arkansas Blue Cross and Blue Shield Prior approval for requested services The primary coverage criteria of certain services must be established through a prior Approval or pre-authorization process before they can be performed. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Prior authorization requirements will be added for the following codes: Not all prior authorization requirements are listed here. Use of the Anthem websites constitutes your agreement with our Terms of Use. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. They may request or review medical records, test results and other information so they understand what services are being performed and are able to make an informed decision. Administrative. Italiano | We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. benefit certificate to determine which services need prior approval. By filling out the form completely and with as much information as possible, you can be sure we have the information to process your request timely. In the case of a medical emergency, you do not need prior authorization to receive care. Please verify benefit coverage prior to rendering services. In Maine: Anthem Health Plans of Maine, Inc. Below that, write the name of the requester (if different than the prescriber) and supply the prescribers NPI number and DEA number. The resources for our providers may differ between states. ABCBS makes no warranties or representations of any kind, express or implied, nor Espaol | the content of any other website to which you may link, nor are ABCBS or the ABCBS Parties liable or responsible Prior authorization requirements are available to contracted providers by accessing the Provider Self-Service Tool at availity.com at anthem.com/medicareprovider > Login. | If you receive services that are not medically necessary from one of Blue Cross of Idahos contracting providers without getting prior authorization and payment for the services is denied, you are not financially responsible. Step 10 On page 2 (1), select yes or no to indicate whether the patient has tried other medications for their condition. FEP Basic Option/Standard OptionFEP Blue Focus. under any circumstances for the activities, omissions or conduct of any owner or operator of any other We currently don't offer resources in your area, but you can select an option below to see information for that state. Step 6 In Medication / Medical and Dispensing Information, describe how the patient paid fortheir medication (include the insurance name and prior authorization number). Step 11 On page 2 (2), list all diagnoses and provide theICD-9/ICD-10. Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification. In some cases, we require more information and will request additional records so we can make a fully informed decision. To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Do you offer telehealth services? Phone - Call the AIM Contact Center at 866-455-8415, Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays. Step 4 In Prescriber Information, specifythe prescribers full name, speciality, and full address. Oromoo | If you're concerned about losing coverage, we can connect you to the right options for you and your family. Select Auth/Referral Inquiry or Authorizations. Step 9 At the top of page 2, provide the patients name and ID number. Availity is solely responsible for its products and services. Please refer to the criteria listed below for genetic testing. In the case of an emergency, you do not need prior authorization. Oct 1, 2020 In Maine: Anthem Health Plans of Maine, Inc. of merchantability or fitness for a particular purpose, nor of non-infringement, with regard to the content Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the Blue Cross and Blue Shield Association. | Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. Please note that CVS Caremark administers the pharmacy benefits for the State Health Benefit Plan. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In the event that the emergency room visit results in the members admission to the hospital, providers must contact Anthem within one business day following admission or post-stabilization. Independent licensees of the Blue Cross and Blue Shield Association. URAC Accredited - Health Plan with Health Insurance Marketplace (HIM) - 7.3, URAC Accredited - Health Utilization Management - 7.4, Member forms - Individual and family plans, Coverage policy and pre-certification/pre-authorization, Approval information for radiological services, Medicare Advantage Prior Authorization Request Form, Part B Medication Prior Approval Request Form, Check deductible and out-of-pocket totals. Step 1 At the top of the form, supply the plan/medical group name, plan/medical group phone number, and plan/medical group fax number. State & Federal / Medicare. . Important: Blueprint Portal will not load if you are using Internet Explorer. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Select Auth/Referral Inquiry or Authorizations. Please verify benefit coverage prior to rendering services. L3924 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, L3925 Finger orthosis, proximal interphalangeal (PIP)/distal interphalangeal (DIP), non-torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. P | In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Typically, we complete this review within two business days, and notify you and your provider of our decision. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Inpatient services and nonparticipating providers always require prior authorization. FEP utilizes Magellan Rx Management for medical, Providers requesting prior approval for an ASE/PSE member should use the appropriate form on the, Providers who are requesting a prior approval for Walmart or other BlueAdvantage members should use the appropriate form from the, Providers who are requesting a prior approval for BlueMedicare or Health Advantage Medicare Advantage members should use the appropriate form from, Providers requesting prior approval for Part B drugs for BlueMedicare or Health Advantage Medicare should use the, Name and telephone number of contact person, Requesting / Performing Providers NPI or Provider ID, Copy of members insurance card (front/back), CPT Code(s), ICD 10/HCPCS Code(s), Modifiers that are applicable, Please use the most descriptive procedure and diagnosis codes, Medical records to support requested services. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. The form contains important information regarding the patient's medical history and requested medication which Anthem will use to determine whether or not the prescription is included in the patient's health care plan. or operation of any other website to which you may link from this website. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Step 13 The prescriber must provide their signature at the bottom of the form and the date of signing. | Step 2 In Patient Information, provide the patients full name, phone number, full address, date of birth, sex (m/f), height, and weight. Independent licensees of the Blue Cross Association. Additionally, providers can use this tool to make inquiries on previously submitted requests, regardless of how they were sent (phone, fax, ICR or another online tool). You can also refer to the provider manual for information about services that require prior authorization. L3927 Finger orthosis, proximal interphalangeal (PIP)/distal interphalangeal (DIP), without joint/spring, extension/flexion (for example, static or ring type), may include soft interface material, prefabricated, L5301 Below knee, molded socket, shin, SACH foot, endoskeletal system, L5321 Above knee, molded socket, open end, SACH foot, endoskeletal system, single axis knee, L5645 Addition to lower extremity, below knee (BK), flexible inner socket, external frame, L5649 Addition to lower extremity, ischial containment/narrow M-L socket, L3250 Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each, 0232T Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, 0397T Endoscopic retrograde cholangiopancreatography (ERCP), with optical endomicroscopy (List separately in addition to code for primary procedure. We currently don't offer resources in your area, but you can select an option below to see information for that state. Franais | Anthem is a registered trademark of Anthem Insurance Companies, Inc. Step 5 In Medication / Medical and Dispensing Information, specify the medication name and indicate whether or not the request is a new therapy or a renewal (if renewal, specifythe date therapy started and the duration). Please update your browser if the service fails to run our website. Please note that CarelonRx is the pharmacy benefits manager for Medicare Advantage plans. federal and Washington state civil rights laws. View pre-authorization requirements for UMP members. Use the Prior Authorization Lookup Tool within Availity or Call Provider Services at 1-855-661-2028. We currently don't offer resources in your area, but you can select an option below to see information for that state. It looks like you're in . Access eligibility and benefits information on the Availity Web Portal or Use the Prior Authorization Lookup Tool within Availity or Contact the Customer Care Center: Outside Los Angeles County: 1-800-407-4627 Inside Los Angeles County: 1-888-285-7801 Customer Care Center hours are Monday to Friday 7 a.m. to 7 p.m. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Call Provider Services at 1-800-450-8753 (TTY 711) After hours, verify member eligibility by calling the 24/7 NurseLine at 1-800-300-8181 To request authorizations: From the Availity home page, select Patient Registration from the top navigation. may be offered to you through such other websites or by the owner or operator of such other websites. nor state or imply that you should access such website or any services, products or information which Obtaining a prior authorization from Blue Cross of Idaho prevents this frustration. link or access, that Arkansas Blue Cross and Blue Shield (ABCBS) is not and shall not be responsible or liable to you or to Visit Anthem.com to learn more about how we coordinate our medical and pharmacy benefits, review our drug lists, submit prior authorization requests, and more. Use of the Anthem websites constitutes your agreement with our Terms of Use. In Connecticut: Anthem Health Plans, Inc. Expand All Our electronic prior authorization (ePA) process is the preferred method for . Commercial non-HMO prior authorization requests can be submitted to AIM in two ways. All rights reserved. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital . ), 33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation, 33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach, 33362 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach, 33363 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach, 33365 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy), 33418 Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis, 33419 Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (List separately in addition to code for primary procedure), 33477 Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed, 33979 Insertion, Ventricular Assist Device, Implantable Intracorporeal, Single Ventricle, 33990 Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; arterial access only, 36514 Therapeutic Apheresis; Plasma Pheresis, 37215 Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection, 55874 Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed, A4224 Supplies for maintenance of insulin infusion catheter, per week, A4225 Supplies for external insulin infusion pump, syringe type cartridge, sterile, each, A5503 For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with roller or rigid rocker bottom, per shoe, A5512 For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees Fah, A5513 For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each, A9580 Sodium fluoride F-18, diagnostic, per study dose, up to 30 millicuries, C1722 Cardioverter-defibrillator, single chamber (implantable), L5671 Addition to lower extremity, below knee (BK)/above knee (AK) suspension locking mechanism (shuttle, lanyard, or equal), excludes socket insert, L5673 Addition to lower extremity, below knee/above knee, custom fabricated, L5679 Addition to lower extremity, below knee/above knee, custom fabricated, L5968 Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature, L5981 All lower extremity prostheses, flex-walk system or equal, L5987 All lower extremity prostheses, shank foot system with vertical loading pylon, L8699 Prosthetic implant, not otherwise specified, L9900 Orthotic and prosthetic supply, accessory, and/or service component of another HCPCS L code. Step 3 In Insurance Information, provide the primary and secondary insurance providersalong with the corresponding patient ID numbers. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. You are invited: Advancing Mental Health Equity for Youth & Young Adults. This website is owned and operated by USAble Mutual Insurance Company, d/b/a Arkansas Blue Cross and Blue Shield. Medical Policy and Clinical Guideline updates are available on our provider website, AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update, Enhancing Provider News website and email communications, Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements, Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines, Specialty pharmacy updates - February 2023, City of Manchester Offers Medicare Advantage Option - New Hampshire, Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023, 2023 FEP benefit information available online, Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Fylnetra), Telephonic-only care allowance extended through April 11, 2023, Anthem Blue Cross and Blue Shield local precertification change in New Hampshire, Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines, New specialty pharmacy medical step therapy requirements, Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list, Notification regarding reimbursement changes to COVID-19 laboratory services codes, Submitting prior authorizations digitally through Interactive Care Reviewer, Outpatient facility revenue code billing requirements, AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update, Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List, Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines, Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines, Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines - Material adverse change, Medical policy and clinical guideline updates available on our provider website, Federal Employee Program observation conversion for musculoskeletal cases, Remittance advice message enhancements: Providing clear descriptions and actionable next steps, Childhood Immunization Status and Lead Screening in Children for HEDIS, Attention lab providers: COVID-19 update regarding reimbursement, December 2022 Provider Newsletter - New Hampshire, Important information about utilization management, IngenioRx will become CarelonRx on January 1, 2023, Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional, Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility, Reimbursement policy update: Bundled Services and Supplies - Professional, Manchester School District in New Hampshire moves to the Medicare Advantage plan with Anthem Blue Cross and Blue Shield, 2023 Medicare Advantage service area and benefit updates, Signature requirements for laboratory orders or requisitions, Reminder - updated AIM Musculoskeletal program effective January 1, 2023 - site of care reviews, Specialty pharmacy updates - December 2022, AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update, Member assessment of PCP after-hours messaging in 2022, Members assessment of behavioral healthcare after-hours messaging in 2022, CAA: Timely updates help keep our provider directories current, Clinical practice and preventive health guidelines available on anthem.com, Pharmacy information available on the provider website, PCP searches in Find Care - New Hampshire, Support documentation for AIM prior authorization requests, November 2022 Provider Newsletter - New Hampshire, Claims status message enhancements: providing clear descriptions and actionable next steps, Submit digital attachments within seven-calendar days for claims filed with a PWK segment indicator, You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too, Visit the Provider Learning Hub to view our latest learning opportunities, Correction to reimbursement policy: Place of Service - Facility, Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline, Medical policy and clinical guideline updates available on anthem.com, Medical drug benefit Clinical Criteria updates, Post office boxes being retired because of low usage, Specialty pharmacy updates - November 2022, CAA: Keep your provider directory information up to date, Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022, COVID-19 Information - New Hampshire - Publication RETIRED as of November 8, 2022, Register for our upcoming CME webinar about low back pain management, CME webinar about low back pain management - New Hampshire, October 2022 Provider Newsletter - New Hampshire. In the event of an emergency, members may access emergency services 24/7. This helps address the issue of rising healthcare costs by keeping procedures and services that are not medically necessary from being performed. Blue Cross of Idaho retains the right to review the medical necessity of services, eligibility for services and benefit limitations and exclusions after you receive the services. Members of the Federal Employee Blue Cross/Blue Shield Service Benefit Plan (FEP) are subject to different prior authorization requirements. To learn more read Microsoft's help article. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. | You can also visit bcbs.com to find resources for other states. | Some procedures may also receive instant approval. A new prior Providers and staff can also contact Anthem for help with prior authorization via the following methods: Pharmacy Prior Authorization Center for Medi-Cal: *For Medicare-Medicaid Plan pharmacy requests, please contact Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Care at 855-817-5786. Secondly, it can be frustrating when a service not covered by your contract is performed by your doctor or specialist. Information about COVID-19 and your insurance coverage. More prior authorization resources Sign in to Availity Non-individual members Use Availity to submit prior authorizations and check codes. Copyright 2001-2023 Arkansas Blue Cross and Blue Shield. Portugus | We look forward to working with you to provide quality service for our members. With prior authorization, Blue Cross of Idaho is able to: Prior authorization is just one of the ways we're working to save our members money and address rising healthcare costs. Contact CVS Caremark by phone at 844-345-3241 or visit their website. Federal Employee Program. Use Availity to submit prior authorizations and check codes. In Connecticut: Anthem Health Plans, Inc. As healthcare costs go up, health insurance premiums also go up to pay for the services provided. If we deny your request for coverage or you have questions regarding your prior authorization, please call Blue Cross of Idahos Customer Service. Use Availity's electronic authorization tool to quickly see if a pre-authorization is required for a medical service or submit your medical pre-authorization request. Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) has an online tool that displays prior authorization guidelines to help you quickly determine whether certain services for Anthem members require a prior authorization. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Register today for the Advancing Mental Health Equity for Youth & Young Adults forum hosted by Anthem Blue Cross and Blue Shield (Anthem) and Motivo* for Anthem providers on March 15, 2023. Denial of MH-TCM services is defined as the initial determination that a member does not meet the criteria for MH-TCM services. An Anthem(Blue Cross Blue Shield) prior authorization form is what physicians will use when requesting payment for a patients prescription cost. Anthem does not require prior authorization for treatment of emergency medical conditions. 1 Services may be listed as requiring prior authorization that may not be covered benefits for a particular member. Prior Authorization Contact Information Providers and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal) Phone: 1-888-831-2246 Hours: Monday to Friday, 8 a.m. to 5 p.m. Fax: 1-800-754-4708 Sign in to the appropriate website to complete your request. . affiliates, its directors, officers, employees and agents ("the ABCBS Parties") are not responsible for TransactRx and CoverMyMeds are separate and independent companies that provide pharmacy pre-authorization and claims submission for Regence members. AIM Specialty Health will transition to Carelon Medical Benefits Management Inc. Anthem Blue Cross and Blue Shield will begin reimbursing for services provided by unlicensed clinical behavioral health providers actively seeking licensure in New Hampshire. If you have any questions regarding our Utilization Management or Prior Authorization process, please call Customer Service at the number on the back of your identification card and they can answer any general inquiries you may have. We look forward to working with you to provide quality services to our members. The best way to ensure you're submitting everything needed for a prior authorization is to use the prior authorization/precertification form at anthem.com/medicareprovider > Providers > Provider Resources > Forms and Guides.