Anthem, Inc. Implementation Resources

myNEXUS is proud to announce its partnership with Anthem, Inc. to provide utilization management for home health services.

Important Network Delegation Announcement

Program Materials

Please follow the links below for program materials:

In-Scope Plan Names

Initial Authorization Form
Re-Authorization Form
Episodic Provider Authorization Form
Home Infusion Therapy Information

Claims: EFT Form

Claims: Appeals Form
Claims: Payment Dispute Request Form

myNEXUS Payer ID for Anthem: 34009

Anthem Standards of Ethical Business Conduct

myNEXUS utilizes CMS National and Local Coverage Determinations (NCD and LCD’s) when applicable, or Anthem medical policies and clinical Utilization Management guidelines to facilitate appropriate evaluation of medical necessity by including assessment of the member throughout the continuum of care. A synopsis of the criteria is available to Providers and Members on request and free of charge by calling myNEXUS at 844-411-9622.

Provider Authorization Portal

myNEXUS Portal
For information on how to register for the portal, please click this link.

Contact Us

Phone: 1-844-411-9622
Fax: 1-844-834-2908

 

Please contact the myNEXUS provider network team with any questions at provider_network@myNEXUScare.com.