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For example, Drug C (cheap) and Drug E (expensive) both treat your condition. If your healthcare provider prescribes Drug E, your health plan may want to know why Drug C won't work just as well. If you can show that Drug E is a better option, it may be pre-authorized.
Log on to Anthem > My Plan and choose "Claims" from the drop-down menu. Scroll to the "Submit a Claim" button at the bottom of the page. Enter the requested contact and claims information and submit.
Care Management support is available 24/7 through Anthem Blue Cross Cal MediConnect Plan Customer Care at 1-855-817-5786.
Authorization in medical billing refers to the process wherein the payer authorizes to cover the prescribed services before the services are rendered. This is also termed as pre-authorization or prior authorization services.
The prior authorization process can help you: Reduce the cost of expensive treatments and prescriptions by first requiring you to try a lower-cost alternative. Avoid potentially dangerous medication combinations. Avoid prescribed treatments and medications you may not need or those that could be addictive.
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By Phone: Call the number on the back of the member's ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative.
In California Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.
No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patient's stabilized condition) provided in any Emergency Department ...
Prior authorizations Anthem makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures, and referrals to validate medical necessity. Prior authorization requirements.
Dignity Health and Anthem Blue Cross terminate California contract, local patients raise concerns. In California, Dignity Health and Anthem Blue Cross have terminated their network agreement. This removes Dignity hospitals and medical clinics across California from Anthem's network.

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