The PCP’s role is to provide members with a medical home, the member’s first stop in the health care process and a centralized hub for a wide variety of ongoing health care needs. The PCP’s role is to: Members enrolled in Anthem Blue Cross (Anthem) may select any contracted PCP as their primary physician as long as that PCP is taking new
patients. We furnish each PCP with a current list of assigned members and from time to time provide medical information about our members’ potential health care needs. In this way, providers can more effectively provide care and coordinate services. Providers can verify that a member is assigned to them any time via Availity. Log in to the Provider Online Reporting tool to view the monthly PCP rosters. For other ways to get in touch regarding PCP verification, please refer to your provider manual or visit the Contact Us page. Staying Healthy Assessment — For Medi-Cal Managed Care (Medi-Cal) onlyThe Staying Healthy Assessment (SHA) is the California Department of Health Care Services’ (DHCS’s) Individual Health Education Behavior Assessment (IHEBA). Medi-Cal providers are required to use and administer the SHA to all members enrolled in Medi-Cal as part of the Initial Health Assessment (IHA) and periodically re-administer it according to contract requirements. Note: This requirement does not apply to members enrolled in Major Risk Medical Insurance Program (MRMIP). PCP responsibilities for the SHA include:
Newly added PCP responsibilities for SHA include:
To obtain SHA formsThe SHA forms in all the age categories and most Medi-Cal threshold languages are posted on the DHCS SHA webpage. Tobacco Cessation Requirements for Medi-Cal providersAnthem is responsible for ensuring PCPs and their qualified staff implement the interventions outlined in MMCD Policy Letter 16-014. This includes identifying all members, initially and annually, of any age who use tobacco products or are exposed to tobacco smoke and document this information in the member’s medical record. This can be accomplished by using the SHA or an equivalent, approved assessment. Providers must ask tobacco users about their tobacco status at every visit and document their responses in their medical record.
Provider tools & resources
Interested in becoming a provider in the Amerigroup network?We look forward to working with you to provide quality services to our members. Is Blue California the same as Anthem Blue Cross?In California Anthem Blue Cross is the trade name of Blue Cross of California.
Is Blue Shield of California part of Anthem?“In California, Anthem Blue Cross and Blue Shield are actually different companies and are competitors. In most other states, they are the same company and formed an association, the Blue Cross Blue Shield Association. Anthem Blue Cross is a for profit company in California, and Blue Shield is a non-profit.
How do I contact Blue Shield of California?Phone: (800) 541-6652, TTY 711, Monday – Friday, 8 a.m. – 5 p.m. Call for questions about: Member eligibility.
Is Anthem Part of MediAnthem serves Medi-Cal recipients in these counties: Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, El Dorado, Fresno, Glenn, Inyo, Kings, Los Angeles, Madera, Mariposa, Mono, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, Santa Clara, Sierra, Sutter, Tehama, Tulare, Tuolumne and Yuba.
What is the fax number for Anthem Blue Cross of California?Phone: Call 1‑888‑831‑2246, option 3 and ask for a form to be faxed to you. Fax: Send your request to: 1-800-754-4708. Anthem Blue Cross is the trade name of Blue Cross of California.
How do I become a Blue Cross provider in California?Practitioners must submit a completed, signed and dated California Participating Practitioner Application, along with other supporting documents identified on the Blue Shield Credentialing Checklist included with the application.
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