Join Our Network

We are glad you are interested in joining the Anthem network in New York. We have a diverse network of exceptional healthcare professionals who help to ensure our members have uninterrupted access to the healthcare they need. We make getting started easy with our online application process.

 

Behavioral health, primary care, specialty care, and non-credentialed providers, please select Begin application

Ancillary providers, please select Join our network

 

 Join Our Network

Credentialing with Anthem

 

Credentialing is the process Anthem uses to evaluate and select licensed independent practitioners to provide care to our members. Anthem uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. This secure and private website reduces the amount of paperwork you need to fill out to complete the credentialing process.

Credentialing Overview

 

Why do we credential?

 

Credentials are evaluated according to criteria set forth in our policy to ensure the competency and conduct of the healthcare professionals serving members in our network

 

Who do we credential?

 

We credential licensed healthcare professionals with whom the company intends to contract and market to our members. Our Program Summary includes a complete list of provider types we credential and those we do not.

 

Please note: Facilities (health delivery organizations) may also need to be credentialed before joining the network.

Credentialing Process

 

1. Register with CAQH (if you are not already registered). You may self-register by visiting proview.caqh.org. This is a secure and private website

 

2. Authorize Anthem so we can access your credentialing information. If you are already registered with CAQH, you will need to give us permission to review your information

 

3. If you need assistance, please review the New Provider Quick Reference Guide or call the CAQH Provider help line at 888-599-1771.

 

4. Review and update your application. Please ensure all sections of the application are complete and accurate.

The credentialing process typically takes 45 days from the time the credentialing department receives your completed CAQH application.

Recredentialing

 

Anthem recredentials network providers every three years. If your CAQH application is current and complete at that time, no additional effort on your part may be required. If CAQH is expired or missing information, we will contact you to update the information.

 

Non-response to recredentialing request

 

If you do not update CAQH or supply the required information for recredentialing by the due date, your application will be considered incomplete and will result in an administrative termination from the network.

Provider rights

 

Providers have the right to:

  • Review information submitted to support their credentialing application.
  • Correct erroneous information.
  • Receive the status of their credentialing or recredentialing application upon request.

 

For a complete list of your credentialing rights as a provider, please review the Practitioner Credentialing Rights. To review your application or correct submitted information, please email our credentialing team at credentialing@anthem.com.

Already in our network?

 

If you are an existing contracted provider with Anthem and you have a question about your network status or participation, please contact our Health Care Networks team.

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Ready to become a provider in the Anthem network?

We look forward to working with you to provide quality service for our members.

 

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.

Begin Application