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Choose from quality doctors and hospitals that are part of your plan with our Find Care tool. Find out if a prescription drug is covered by your plan. Browse commonly requested forms to find and download the one you need for various topics including pharmacy, enrollment, claims and more.
Use this form to file a claim when your doctor doesn’t file the claim for you. You should send this completed claim form as soon as possible after you get care.
On this page you can easily find and download forms and guides with the information you need to support both patients and your staff. Ready to become a provider in the AnthemBlueCross network? We look forward to working with you to provide quality service for our members.
Medical Claim Form. HIPAA Authorization Form. Transition Assistance Form. Disabled Dependent Certification. Pharmacy Claim Form – Note: this form is only to be used if you are on the Anthem HMO or HSA plans. For a full list of forms, visit Anthem's website: anthem.com/ca/forms.
Forms. A library of the forms most frequently used by health care professionals. Looking for a form, but don’t see it here? Please contact us for assistance. Prior Authorizations.
A library of the forms most frequently used by healthcare professionals is available. Looking for a form but don’t see it on this page? Please contact your provider representative for assistance.
sa m pl e please print or type approved omb-0938-1197 form 1500 (02-12) . created date: 3/17/2014 12:41:41 pm
