Find the right department

Carelon handles specialty UM (e.g., imaging) for Anthem Ohio Medicaid; portal providerportal.com or Availity.

Claim disputes: Availity claim status dispute button, mail, or by phone. External medical review requests go to Permedion (hmspermedion.com).

Dental claims and PA go directly to LIBERTY Dental Plan.

Report suspected fraud/abuse to Anthem; ODM and Ohio AG MFCU also accept reports.

Concurrent reviews for inpatient and admission requests for SNF/LTAC/acute rehab/NF. Elective admissions and outpatient surgery precertification use the separate MPA PA fax line listed in the manual. Availity is preferred.

Medical (provider-administered) injectable drug PA requests; check PA requirement in the Anthem Ohio PLUTO tool.

Member-facing; 24/7 NurseLine 844-430-0341.

Provider call center for Anthem MyCare Ohio. QCG lists 844-912-1226 for MyCare too; this page lists a separate MyCare call center.

NEMT for Anthem Ohio Medicaid members.

Outpatient: home health, PT/OT/ST, private duty nursing, DME, chiropractic, acupuncture. Availity is preferred.

Send Recoupment Notification Form / Overpayment Refund Notification Form with refunds.

Physical health care management referrals; phone via provider services 844-912-1226.

Provider appeals and member-consented authorization appeals (Ohio Standardized Appeal form); expedited appeals also by this fax. Electronic option: Availity Interactive Care Reviewer.

Anthem Blue Cross and Blue Shield Medicaid (Ohio Medicaid managed care and MyCare): eligibility, claims, UM and behavioral health, interpreter help, verbal claim disputes. Paper claims are not accepted; submit via ODM trading partner (OMES) with EDI Payer ID 0002937 or Availity direct data entry.

Routine vision; claims go directly to EyeMed.

Acute inpatient notifications and all outpatient requests. Facility clinical fax 877-423-9972. Peer to peer 800-262-2731.

Individual Medicare Advantage (MediBlue) appeals and grievances.

MA case management (Central region).

SNF, LTAC, inpatient rehab and non-acute inpatient initial/concurrent reviews; facility clinical fax.

Contact provider services before returning checks.

1099 requests only. | Provider 1099 form requests.

SOAP notes/medical records via Inovalon ONE Converged Patient Assessment or fax. | SOAP notes and medical records for risk adjustment via Inovalon ONE (Converged Patient Assessment) or fax. Inovalon help desk 877-448-8125.

Single line for all provider questions.

Anthem Blue Cross pharmacy PA center for Medi-Cal and MRMIP. Medi-Cal pharmacy-benefit drugs are administered by Medi-Cal Rx (800-977-2273); confirm which benefit applies.

Behavioral health prior authorization requests for Anthem Medi-Cal.

Case management referrals and coordination for Anthem Medi-Cal members.

Community-Based Adult Services requests for L.A. County members; other counties fax 855-336-4041.

ECM referrals (Availity preferred, or secure email/fax).

Physician/provider grievances and appeals for Anthem Medi-Cal.

LTSS requests for Southern California (Northern California fax 844-285-1167).

Request a peer-to-peer discussion with a Medical Director about a PA decision.

Contracting questions per the July 2026 Medi-Cal manual.

UM fax listed for delegated groups performing UM.

Medi-Cal route. Other products have separate contacts.

Customer care for the Major Risk Medical Insurance Program.

HIV/AIDS specialty plan (Clear Health Alliance) case managers.

24/7 behavioral health crisis line listed in the Healthy Blue MO provider manual contact table.

Paper behavioral health inpatient prior authorization requests (Availity preferred).

Paper behavioral health outpatient prior authorization requests (Availity preferred). Substance use services are carved out to MO HealthNet; ABA is carved out to MO HealthNet.

Blue View Vision (vision services vendor) number listed in the Healthy Blue MO quick reference card.

Carelon manages PA for CT/MRI/PET, nuclear cardiology, echo, radiation oncology, sleep medicine, cardiology and musculoskeletal (spine) services for Healthy Blue MO Medicaid.

Written reconsiderations and claim payment appeals; disputes must be received within 365 days of the EOP. Availity Payment Appeal tool is the online option; verbal reconsiderations via provider services.

DentaQuest provider line for Healthy Blue Missouri Medicaid dental (member line differs).

Medical (medical necessity) appeals filed by a provider on behalf of the member with written consent, within 60 calendar days of the notice.

MTM nonemergency medical transportation (NEMT/NEAT) member ride line; also handles non-emergent air ambulance.

Healthy Blue Missouri (MO HealthNet Managed Care, Elevance/Blue Cross Blue Shield of Kansas City). Availity Authorization and Referral app is preferred; phone requests go to provider services 833-405-9086. Same shared Elevance outpatient fax used by other Elevance Medicaid plans.

CMS-1500/UB-04 original red-ink forms. Timely filing 180 calendar days from DOS. Claim status via Availity or the provider services IVR (833-405-9086).

Inpatient admission notifications and concurrent clinical submissions for medical necessity review; discharge information within one business day.

Case management for Healthy Blue Dual Advantage members.