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Information for California

EDI Companion Guide

The companion guide provides supplemental instructions for EDI transmissions specific to Anthem.  All new submitters will use the Availity EDI Gateway for their Anthem EDI transactions.

Section A: EDI User Guide

For employer groups: 834 User Guide

For all other transactions: Availity EDI Connection Guide

Section B: Transaction-specific Documents

Health Care Claim: 837I | 837I (Encounters) | 837P | 837P (Encounters) | 837D

Health Care Claim Payment/Advice: 835

Benefit Enrollment and Maintenance: 834 | 834 (Compass Life & Disability)

Payroll Deducted & Other Group Premium Payment for Insurance Products: 820

Prior Authorization: 278

Claim Status: 276/277 (Batch) | 276/277 (Real-time)

Eligibility: 270/271 (Batch) | 270/271 (Real-time)

Medical Attachments: 275

Inpatient Admission and Discharge Notification: 278N

Review Notification & Acknowledgement - Referrals: 278N

Review Notification & Acknowledgement - UM Decisions: 278N

Availity Companion Guide

In addition to our companion documents listed above, Availity also offers a companion guide to communicate Availity-specific requirements and other supplemental information.
 
Access Availity's Companion Guide
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Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place.
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In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan’s network. If you receive care from a doctor or healthcare provider not in your plan’s network, your share of the costs may be higher. You may also receive a bill for any charges not covered by your health plan.
 
® Anthem is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association © 2022 Anthem Blue Cross. Serving California.
 
Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of your health plan. ©2020-2022 The Virtual Primary Care experience is offered through an arrangement with Hydrogen Health.