Anthem Online Provider Services Quick Reference Guide - 1st

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Anthem Online Provider Services Quick Reference Guide - 1st Powered By Docstoc
					                                                                      Anthem Online Provider Services Quick Reference Guide – December 2006
                                              Plan Identifiers                                                                             Coverage & Benefits Search                                                                    Claim Status Search
                                            (Member ID prefixes)                                                                                 Requirements                                                                               Requirements
         Local Anthem plans (including but not limited to: BlueCare, BlueChoice, Century Preferred, HMO Choice, Maine Partners Health Plan and Matthew Thornton Blue )
         Local / New England Health Plan (NEHP) Home                             Option 1: Member ID and first initial of First Name (full First                     Member ID and first initial of First Name (full First
                CT = ABE, AEF, ALQ, ATM, AUT, BCR, BDF, BIC, CDL, CKC, CKE, CMY,              Name and/or Date of Birth may also be required)                        Name and/or Date of Birth may also be required)
                CTN, CTP, CTZ, DYA, EAG, EBG, ECT, GDC, HHC, HJB, HPB, ITD, LBG, -----------------------------------------------------------------------------------
                LBR, LGI, LNA, LOS, KPB, MCK, MGG, NSN, NUM, OAK, OAT, OHS, OTT, Option 2: First Name, Last Name and Date of Birth
                OTW, PHT, PLY, PRG, PTA, PTB, PTY, SFC, SMI, TCT, TSG, TRD, TUV,
                ULR, UNF, WBT, WMO and XG
                ME = HCN, MEN, MEP and XV
                NH = NHN, NHP and YG
                                                                                                                                                                                                            Member ID and first initial of First Name (full First
         Behavioral Health                                                                                             tOption 1: Member ID and first initial of First Name (full First
                                                                                                                                                                                                            Name and/or Date of Birth may also be required)
                                                                                                                                      Name and/or Date of Birth may also be required)
                                                                                                                        -----------------------------------------------------------------------------------
                                                                                                                        Option 2: First Name, Last Name and Date of Birth
         State and Federal Government Programs
                                                                                                                        Option 1: Member ID and first initial of First Name (full First                     Member ID and first initial of First Name (full First
         BlueCare Family Plan (applicable to CT only)
                                                                                                                                      Name and/or Date of Birth may also be required)                       Name and/or Date of Birth may also be required)
         J
                                                                                                                        -----------------------------------------------------------------------------------
                                                                                                                        Option 2: First Name, Last Name and Date of Birth

                                                                                                                                                                                                            Member ID and first initial of First Name (full First
         Medigap / Medicare Supplemental                                                                               Option 1: Member ID and first initial of First Name
                                                                                                                                                                                                            Name and/or Date of Birth may also be required)
         XGM, XVB and YGM                                                                                               -----------------------------------------------------------------------------------
                                                                                                                        Option 2: First Name, Last Name and Date of Birth
                                                                                                                        Option 1: Member ID Number, full First Name, Last Name,                             Member ID and first initial of First Name (full First
         Federal Employee Program (FEP)
                                                                                                                                       Date of Birth and Relationship                                       Name and/or Date of Birth may also be required)
         R
                                                                                                                        -----------------------------------------------------------------------------------
                                                                                                                        Option 2: Not Available
         Taft Hartley Plans                                                                                                                                                                                 Member ID, First and Last name, Date of Birth, and
                                                                                                                           Not Available
         CCU, CWV, ELH, EWU, IRU, IUB, IUP, NEF, NIW, PSH, PTH, SVL, TLH,                                                                                                                                   Relationship (full subscriber name/and or first 2
         TSJ, WVF                                                                                                                                                                                           characters of provider last name may be required)

                                                                                                                                                                                                                    Note: The Member ID must be 10 characters in
                                                                                                                                                                                                                    length. If the number on ID card is less than ten, add
                                                                                                                                                                                                                    zeros after the prefix. For Maine and New Hampshire
                                                                                                                                                                                                                    members, claims submitted/processed prior to
                                                                                                                                                                                                                    12/10/2006 are not available.



P04018 12/23/06 rev.       Anthem Blue Cross and Blue Shield is the trade name for the following: In Connecticut: Anthem Health Plans, Inc. In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In
Maine: Anthem Health Plans of Maine, Inc. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. Independent licensees of the Blue Cross and
Blue Shield Association. Independent licensees of the Blue Cross and Blue Shield Association. ® Registered marks of the Blue Cross and Blue Shield Association
                                   Plan Identifiers                                                  Coverage & Benefits Search                                                       Claim Status Search
                                 (Member ID prefixes)                                                      Requirements                                                                  Requirements
       Regional and National Accounts
                                                                                 Option 1: Member ID Number, full First Name, Last Name,                                Member ID, First and Last Name, Date of Birth,
       MediBlueSM HMO
                                                                                                Date of Birth and Relationship                                          Relationship, Claim Number and Provider Tax ID
       XGH
                                                                                 ------------------------------------------------------------------------------------
                                                                                 Option 2: Not available
                                                                                 Option 1: Member ID, full First Name, Last Name, Date of                               Member ID, First and Last name, Date of Birth, and
       Other Blue Cross® and Blue Shield® Plans / BlueCard® Program
                                                                                 Birth and Relationship                                                                 Relationship, (full subscriber name and/or first 2
       multiple prefixes
                                                                                 ------------------------------------------------------------------------------------   characters of provider last name may be required)
                                                                                 Option 2: Not available
       New England Health Plan (NEHP) Host                                       Option 1: Member ID, full First Name, Last Name, Date of                             Member ID, First and Last name, Date of Birth, and
              MA = MTN and MTP                                                   Birth and Relationship                                                               Relationship, (full subscriber name and/or first 2
              RI = HPP and HPN                                                   ------------------------------------------------------------------------------------ characters of provider last name may be required)
              VT = PVN and PVP                                                   Option 2: Not available
       Accounts for whom Anthem is control plan                                  Option 1: Member ID and first initial of First Name (full First                      Member ID and first initial of First Name (full First
              CT = BCR, BDF, CCU, EBG, ELH, GBK, LOS, NBF, NEH, PTA, PTH, SVL,                 Name and/or Date of Birth may also be required)                        Name, Date of Birth and/or first 2 characters of
              TLD, TLH and TSG                                                   ------------------------------------------------------------------------------------ Provider’s Last Name may also be required)
              OH = AAG, AAQ, ADD, ADL, AEI, AHE, AIP, AKE, AKN, AKO, AKP, AKS,   Option 2: Not available
              AKZ, AMB, AMD, AMJ, AMV, AMZ, ANB, ANK, ANT, ANW, ANX, APH, APS,
              APU, AQI, ARC, ARG, ARM, ARU, ASH, ASJ, ASQ, ATX, ATZ, AUC, AUL,
              AUR, AWL, AWT, AXA, AXE, BAE, BER, BFC, BFX, BHR, BKN, BKO, BPE,
              BPT, BYB, BYR, CBI, CBK, CBO, CBP, CBS, CBT, CDH, CKH, CRR, CSG,
              CTD, CUA, CVA, CVE, CVF, CVP, CVR, CWG, CWQ, CZC, CZT, DCB, DCO,
              DEM, DFL, DHR, DII, DJC, DJG, DNL, DOR, DPH, DRI, DSA, DTE, DTT,
              DWY, DZA, EAM, EBX, ELS, ELY, ESL, EXA, FBD, FEC, FEF, FHM, FOL,
              FOR, FRA, FRH, FRU, GCP, GCT, GJP, GLN, GLY, GMR, GTE, GTR, GVR,
              GVZ, GYC, GYO, GYR, GYS, HBI, HBS, HEW, HIA, HNB, HNC, HNP, HNS,
              HOU, HWP, HXL, IJN, KBL, KBS, KIM, KNA, KPA, KRG, KRH, KRO, LBB,
              LDL, LDR, LGC, LGE, LGE, LGH, LLY, LNC, LNR, LON, LSS, MCV, MTA,
              MUF, MWE, MWV, MYE, MYM, NDN, NDO, NIJ, NIS, NOI, NRJ, NSU, NWM,
              ONB, OSN, OVS, PCO, PFL, PFN, PHQ, PLH, PLN, PPI, PPS, PWR, PYT,
              RCZ, RDG, RHE, RLL, RMK, RRA, RSJ, RSP, RUM, RZT, SDN, SEG, SHB,
              SHU, SHZ, SJA, SLM, SMC, SMD, SMM, STX, SWG, SWL, TAI, TMC, TMD,
              TMP, TOA, TOO, TOT, TRW, TTC, TTZ, UMP, UNM, UNX, URM, UTO, UTT,
              UTX, WCI, WCK, WGL, WJO, WMO, WSG, WSQ, WTA




P04018 12/06 rev.                                                                                                                                         2
                                     Plan Identifiers                                                       Coverage & Benefits Search                                            Claim Status Search
                                   (Member ID prefixes)                                                           Requirements                                                       Requirements
       Regional and National Accounts
       Other Anthem plans                                                                   Option 1: Member ID, full First Name, Last Name, Date of Birth Member ID and first initial of First Name (full First
              CO = CST, RAF, RAG, SHP and XF                                                 and Relationship                                                       Name, Date of Birth and/or first 2 characters of
              IN = XP                                                          ------------------------------------------------------------------------------------ Provider’s Last Name may also be required)
              KY = ICC and XT                                                  Option 2: Not available
              NV = YF
              OH = EAL, FDB, FNK, ISG, IST, and YR
              VA = AAL, AAV, ABN, ABW, ACJ, AFA, AKT, ANN, ANR, ASE, ASN, ASP,
              AWC, AWP, BAV, BFU, BOD, BSG, BUN, BVA, BWX, CAH, CCP, CFP, CFX,
              CKA, CLF, CLQ, CLU, CMF, CML, CPP, DOB, DTS, EAC, EEL, EWC, FAP,
              FTE, FTG, FTU, FVC, GEV, GFM, HCI, HCR, HEC, HEP, HFC, HHR, HRH,
              HUN, HWM, ITG, LAN, LCC, LCP, LFG, LPS, MBB, MEB, MEU, MGN, MGS,
              MIA, MLP, MLT, MMS, MMT, MRL, MTC, MVC, MVP, MVS, MWB, MWP, NNS,
              NOL, NOO, NSC, NSR, PDE, PDQ, PDR, PIN, PRE, PRP, PSF, PTP, PVD,
              PWG, PWS, RBX, ROA, RRY, RVI, SFA, SFR, SPA, SSB, SSC, STK, SUL,
              SWP, TCD, TED, TEF, TFA, THP, TTL, ULS, UNC, USI, USL, VOL, VOV,
              WFP, WIL, WLI, WLR and WTY




P04018 12/06 rev.                                                                                                                                      3

				
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