Anthem, Inc. Implementation Resources
myNEXUS is proud to announce its partnership with Anthem, Inc. to provide utilization management for home health services.
- Connecticut Announcement for April 15, 2019
- Updates for portal re-registration will be provided to agencies and also posted on this page. Please check here for updates.
- To view program announcements, please click here.
Please follow the links below for program materials:
In-Scope Plan Names
Initial Authorization Form
Episodic Provider Authorization Form
Home Infusion Therapy Information
Claims: EFT Form
Claims: Appeals Form
Claims: Payment Dispute Form for In-Network Providers
Claims: Payment Dispute Form for Out of Network Providers
myNEXUS Payer ID for Anthem: 34009
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
Please contact the myNEXUS provider network team with any questions at provider_network@myNEXUScare.com.