Payer-Specific Service

Anthem Credentialing & Enrollment

Specialized credentialing and enrollment services for Anthem Blue Cross Blue Shield plans across all 14 states. Get in-network with one of the nation's largest health insurers and access millions of members.

900+ Anthem Providers

14 States Covered

97% Approval Rate

Start Anthem Enrollment Free Anthem Consultation

14-State Coverage

Complete Anthem Enrollment

Commercial, Medicare Advantage, and Medicaid plan credentialing

Our Process

Anthem Credentialing Made Efficient

Our streamlined 3-step process ensures your Anthem enrollment is completed accurately across all required states.

CAQH & Availity Setup

We ensure your CAQH ProView profile is complete and attested, and set up your Availity provider portal access for Anthem.

Multi-State Application Submission

We prepare and submit credentialing applications to Anthem plans in each required state with all plan-specific documentation.

Follow-Up & Contracting

We track applications across all states, respond to Anthem requests, and assist with contract review and signature.

Anthem Plans We Cover

All Anthem Plan Types

We credential providers for all Anthem commercial, Medicare, and Medicaid products.

Anthem Commercial

PPO, HMO, EPO, and POS plans for employer groups

Anthem Medicare Advantage

Medicare HMO, PPO, and Dual Eligible plans

Anthem Medicaid

State-specific Medicaid managed care programs

Anthem Exchange Plans

ACA Marketplace individual and family plans

Anthem FEP

Federal Employee Program for government employees

Anthem Self-Funded

ASO and level-funded employer plans

Anthem Vision

Blue View Vision plans

Anthem Dental

Dental PPO and prepaid plans

Anthem States We Serve

14-State Coverage Area

We credential providers with Anthem Blue Cross Blue Shield plans across all 14 states where Anthem operates.

California

Anthem Blue Cross of California

Colorado

Anthem Blue Cross Blue Shield of Colorado

Connecticut

Anthem Blue Cross Blue Shield of Connecticut

Georgia

Anthem Blue Cross Blue Shield of Georgia

Indiana

Anthem Blue Cross Blue Shield of Indiana

Kentucky

Anthem Blue Cross Blue Shield of Kentucky

Maine

Anthem Blue Cross Blue Shield of Maine

Missouri

Anthem Blue Cross Blue Shield of Missouri

Nevada

Anthem Blue Cross Blue Shield of Nevada

New Hampshire

Anthem Blue Cross Blue Shield of New Hampshire

New York

Anthem Blue Cross (Empire)

Ohio

Anthem Blue Cross Blue Shield of Ohio

Virginia

Anthem Blue Cross Blue Shield of Virginia

Wisconsin

Anthem Blue Cross Blue Shield of Wisconsin

Core Requirements

Anthem Credentialing Essentials

We ensure all Anthem credentialing requirements are met with precision.

CAQH Attestation

Current CAQH profile with recent attestation (within 120 days)

State Medical License

Active, unrestricted license in practicing state

DEA Registration

Valid DEA certificate for controlled substances

Board Certification

ABMS or AOA board certification status

Malpractice Insurance

Minimum coverage per Anthem requirements

Work History

Complete 5-year work history with gap explanations

W-9 Form

Current IRS W-9 for tax identification

Background Screening

OIG, SAM, and NPDB clearances

Why Choose Us

Anthem Credentialing Excellence

We understand Anthem's specific credentialing requirements across all 14 states.

14-State Expertise

Deep knowledge of Anthem credentialing requirements across all states where Anthem operates.

Availity Portal Mastery

Expert navigation of Availity, Anthem's primary provider portal for credentialing and claims.

Multi-State Coordination

We manage simultaneous applications across multiple Anthem state plans, reducing administrative burden.

Recredentialing Support

Ongoing monitoring and management of Anthem's 3-year recredentialing cycles across all states.

FAQ

Anthem Credentialing Questions Answered

Clear answers to common questions about Anthem credentialing.

How long does Anthem credentialing take?

Anthem credentialing typically takes 60-90 days from application submission to effective date. Our expedited process helps minimize delays.

Does Anthem require CAQH?

Yes, Anthem requires providers to maintain a current, attested CAQH ProView profile. Re-attestation is required every 120 days.

What is Availity and do I need it for Anthem?

Availity is Anthem's primary provider portal for credentialing, claims submission, and eligibility verification. We help set up and manage your Availity account.

Do I need separate credentialing for each Anthem state?

Yes, each Anthem state plan operates independently and requires separate credentialing. We manage all applications simultaneously.

What is Anthem's recredentialing cycle?

Anthem requires recredentialing every 3 years. We track cycles across all states and manage the complete recredentialing process.

Does Anthem require site visits?

Site visits may be required for certain specialties or high-volume practices. Requirements vary by state and specialty.

Can I join Anthem Medicare Advantage separately?

Yes, Anthem Medicare Advantage requires separate credentialing from commercial plans. We manage both processes simultaneously.

What is Anthem's relationship with BCBS?

Anthem is the largest for-profit Blue Cross Blue Shield licensee, operating BCBS plans in 14 states. Credentialing follows BCBS standards.

Does Anthem credential non-physician providers?

Yes, Anthem credentials Nurse Practitioners, Physician Assistants, and other advanced practice providers. Requirements vary by state.

What about Anthem's Empire plan in New York?

Anthem operates as Empire Blue Cross in New York. We have extensive experience credentialing with Empire for New York providers.

Ready to Join Anthem's Network?

Let our Anthem credentialing experts get you in-network across all required states and start seeing millions of Anthem members.

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