Providers
As a healthcare provider, you can access our fax back system and receive a fax printout that will verify member eligibility, check status of a medical, dental, or vision claim, and verify benefits by calling our automated system at 1-800-472-7130 extension 5590.

Anthem Blue Cross Blue and Shield Provider Resources

The Anthem Blue Cross and Blue Shield in Wisconsin Provider Site contains many useful resources

Anthem Medical Policies

Anthem Blue Cross and Blue Shield in Wisconsin Medical Policies

Claim Submission and Formats

Information regarding submission of claims and formats.

HIPAA Contingency Information

Claim Management Services Contingency Plan for Electronic Transactions after the 10/16/03 HIPAA Compliance Deadline

Procedure for Overpayment Requests
Information regarding the Anthem Procedure for handling overpayments to Providers.

Claims Category Codes

The list of claims categories where we may routinely require submission of Clinical Information before or after payment of a claim.

Consent for Release of Clinical Information
Individual Authorization Form

Individual Authorization Form - Psychotherapy Notes

Precertification Requirements
Minimum Requirements for Precertification

Claims Processing Edits
Significant Edits

Limited Code Combinations for Modifiers 25 and 59

Provider Internal Appeals Process
Provider Correspondence - Claim Reconsideration Request
Claim Reconsideration Request Form

Physician Advisory Council
Information about our Physician Advisory Council

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