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Anthem Blue Cross Blue Shield of New York

Anthem BCBS NY

Anthem Blue Cross Blue Shield of New York logo

Provider portalapps.availity.com ↗

Primary payer ID
Compare transaction IDs ↓
Last successful claim statusWithin the past 48 hoursObserved across Substrate's claim-status network.
SupportedEDI 276/277EDI 270/271Browser automation

Coverage profile

Work Anthem Blue Cross Blue Shield of New York across every published route

Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Anthem Blue Cross Blue Shield of New York.

Available

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Anthem Blue Cross Blue Shield of New York.

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for Anthem Blue Cross Blue Shield of New York.

Available

Other aliases

Also known as

  • 00303
  • 00803
  • 00803R
  • 10043
  • 303
  • 4437
  • 803
  • EIJLI
  • EMHECH
  • NYBLS
  • SB803
  • SB803MA
  • Anthem Blue Cross Blue Shield of New York - Medicare Advantage
  • Anthem HealthChoice Assurance
  • Anthem Insurance Companies
  • Empire Blue Cross Blue Shield - Anthem Blue Cross Blue Shield New York
  • Empire Blue Cross Blue Shield - Anthem Blue Cross Blue Shield New York (Medicaid Reclamation)
  • ANTHEM BC NY
  • EMPIRE BCBS - ANTHEM BCBS NY (MEDICAID RECLAMATION)
  • EMPBSNY803
  • EMPBCNY303
  • ANTHEM BCBS NY
  • EMPIRE BC - ANTHEM BC NY (MEDICAID RECLAMATION)

Payer intelligence

Observed adjudication timing

How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.

Median time to payment

8.3 days
10% of adjudications by
7 days
90% of adjudications by
14 days
Applicable state coverage
GA
Current As Of
July 2026

Five-month median trend

Days to 835 payment
Anthem Blue Cross Blue Shield of New York median observed adjudication timingMonthly median days from payer receipt to 835 payment from April 2026 through August 2026. Missing qualified months are shown as gaps.07.515AprMayJunJulAug
View chart data as a table
Anthem Blue Cross Blue Shield of New York observed adjudication timing by service month
Service monthMedian10% of adjudications by90% of adjudications byCompleted claimsCoverage
Apr11 days7 days39 days352GA
May11 days7 days16 days745GA
Jun8.1 days7 days14 days728GA
Jul8.3 days7 days14 days645GA
AugNo qualified data

2027 maternity billing research

When does Anthem Blue Cross Blue Shield of New York change OB/GYN billing?

Confirmed 2027 guidance

Anthem's New York Medicaid article announces maternity coding restructuring effective January 1, 2027. It directs NYS Medicaid-enrolled maternity providers to use the restructured system for services to individuals initiating prenatal care on or after June 1, 2026, and/or having an estimated due date on or after January 1, 2027. Antepartum and postpartum care are reported per encounter using E/M codes; labor management and delivery are reported separately. The article refers providers to the April 2026 NYS Medicaid Update for additional billing guidance.

Transition start
Prenatal-care initiation on/after 2026-06-01 and/or estimated due date on/after 2027-01-01
Billing start
CPT restructuring effective 2027-01-01; earlier cohort instruction requires clarification
Published
2026-04
Current As Of
August 2026

Scope: New York Medicaid maternity medical services; coverage identified as Anthem Blue Cross and Blue Shield HP, trade name of Anthem HP, LLC. Applicability to commercial, Medicare, dental, or vision products is not established.

2027 maternity care coding restructuring. Verify the payer source before claim submission.

Frequently asked questions

Anthem Blue Cross Blue Shield of New York payer FAQs

How do I check claim status with Anthem Blue Cross Blue Shield of New York?

Providers check Anthem Blue Cross Blue Shield of New York via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.

What is the payer ID for Anthem Blue Cross Blue Shield of New York?

The primary payer ID for Anthem Blue Cross Blue Shield of New York is 803. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.

What is the provider portal for Anthem Blue Cross Blue Shield of New York?

The provider portal for Anthem Blue Cross Blue Shield of New York is https://apps.availity.com/. Available features depend on the payer and your account.

What are the 837 payer IDs for Anthem Blue Cross Blue Shield of New York?

The 837P and 837I payer ID for Anthem Blue Cross Blue Shield of New York is 803 via Stedi.

What is the 835 payer ID for Anthem Blue Cross Blue Shield of New York?

The 835 payer ID for Anthem Blue Cross Blue Shield of New York is 803 via Stedi.

What is the 270 payer ID for Anthem Blue Cross Blue Shield of New York?

The 270 payer IDs for Anthem Blue Cross Blue Shield of New York are 803 via Stedi and 803 via Availity.

What is the 276 payer ID for Anthem Blue Cross Blue Shield of New York?

The 276 payer IDs for Anthem Blue Cross Blue Shield of New York are 803 via Stedi and 803 via Availity.

What state does Anthem Blue Cross Blue Shield of New York operate in?

Anthem Blue Cross Blue Shield of New York operates in NY.

Routing reference

Anthem Blue Cross Blue Shield of New York payer IDs and operating states

Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.

Anthem Blue Cross Blue Shield of New York payer name, operating states, and transaction-specific payer IDs
Payer nameAnthem Blue Cross Blue Shield of New YorkSource: Substrate payer directory · last refreshed
Operating statesNYSource: Substrate payer directory · last refreshed
837P professional claims payer IDStedi803Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi803Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi803Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi803Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvaility803Source: Availity payer catalog · catalog dated · matched by payer ID
276 claim status payer IDStedi803Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvaility803Source: Availity payer catalog · catalog dated · matched by payer ID

Routing sources and verification

  • Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
  • Stedi payer catalogMatched by payer ID; matched record: Anthem Blue Cross Blue Shield of New York. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
  • Availity payer catalogMatched by payer ID; matched record: ANTHEM BCBS NY. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
  • United Clearinghouse payer catalogMatched by payer name; matched record: Anthem Blue Cross Blue Shield of New York. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Payer contact directory

Anthem Blue Cross Blue Shield of New York phone and fax numbers

Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.

Eligibility / benefits phone
(800) 676-2583ANTHEM
Payer fax
(501) 212-8518ANTHEM
Anthem Blue Cross Blue Shield of New York payer phone and fax directory
Channel and numberPayer NotesDepartmentSpecialties
fax(866) 411-2573Prior authorizationBenefit context: Co-Insurance
  • ACUTE INPATIENT REHABILITATION ADMISSION PRECERTIFICATION
  • SKILLED NURSING FACILITY ADMISSION PRECERTIFICATION
Hospital
fax(866) 411-2585Prior authorizationBenefit context: Co-Insurance
  • ACUTE INPATIENT HOSPITAL ADMISSION PRECERTIFICATION
Hospital
fax(410) 781-7661Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • UTILIZATION MANAGEMENT
fax(800) 453-4341Other stated contextBenefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
fax(833) 453-0101Other stated contextBenefit context: Coverage Basis
  • REACH KIDNEY CARE
fax(833) 938-9934Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible
  • CREDENCE BCBS
Hospital
fax(844) 295-4637Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
fax(866) 606-6021Other stated contextBenefit context: Coverage Basis
  • PA LOGIC SOLUTIONS
fax(866) 900-2491Other stated contextBenefit context: Co-Insurance
  • VBA CARE MANAGEMENT
Hospital, Hospital - Inpatient
fax(501) 212-8518
  • ANTHEM
fax(888) 282-1321
  • ANTHEM
phone(312) 738-0822Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CENTRAL STATES JOINT BOARD
Hospital, Hospital - Inpatient
phone(516) 794-7700Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DDS
Dental Care
phone(718) 745-3487Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • FUND
Dental Care, Pharmacy
phone(800) 224-5513Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPT
Pharmacy
phone(800) 224-7976Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS
Pharmacy
phone(800) 237-6060Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 244-6224Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CIGNA
Dental Care
phone(800) 255-5681Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DDS
Dental Care
phone(800) 268-9012Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIBERTY DENTAL
Dental Care
phone(800) 318-2572Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CAREMARK CVS
Pharmacy
phone(800) 321-0935Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CHESTERFELD RESOURCES, INC.
Dental Care
phone(800) 322-6384Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTI-CAL
Dental Care
phone(800) 332-0366Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • UNITED CONCORDIA
Dental Care
phone(800) 334-8134Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ESI/RX BENEFITS
  • OPTUM RX
  • RX BENEFITS CVS CAREMARK
  • RXBENEFITS
Pharmacy
phone(800) 335-8266Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL OF MO
Dental Care
phone(800) 343-9000Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • NEW YORK MEDICAID FFS
Chiropractic, Hospital - Inpatient, Hospital - Outpatient, Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services, Pharmacy, Physician Visit - Office: Well, Mental Health
phone(800) 356-3477Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(800) 424-0472Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MAGELLAN RX MANAGEMENT
Pharmacy
phone(800) 441-9188Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Emergency Services, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Hospital - Outpatient, Hospital, Hospital - Inpatient
phone(800) 450-8753Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Hospital, Pharmacy, Urgent Care
phone(800) 451-0287Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
Hospital, Hospital - Inpatient
phone(800) 452-9310Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 520-3368Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SELE-DENT INC
Dental Care
phone(800) 521-3605Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EYEMED
Vision (Optometry)
phone(800) 522-1313Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DHA
Dental Care
phone(800) 523-4702Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • NATIONAL ELEVATOR INDUSTRY HEALTH BENEFIT PLAN
Physician Visit - Office: Well
phone(800) 524-0149Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL OF OHIO
Dental Care
phone(800) 576-2145Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ALICARE
Dental Care
phone(800) 577-1278Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • INDIANA MEDICAID
Mental Health
phone(800) 626-3643Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BEHAVIORAL HEALTH
Mental Health
phone(800) 627-4200Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • GUARDIAN
Dental Care
phone(800) 631-7780Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MEDCO
Pharmacy
phone(800) 634-4832Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • KEPRO
Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services
phone(800) 635-1928Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BCBSIL
Hospital, Hospital - Inpatient
phone(800) 662-8856Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 676-2583Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ANTHEM
  • BCBS OF MISSISSIPPI
  • BCBSTX
  • CUSTOMER SERVICE
Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Physician Visit - Office: Well, Urgent Care, Professional (Physician) Visit - Office, Vision (Optometry)
phone(800) 687-0707Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MAXORPLUS
Pharmacy
phone(800) 692-2489Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • GHI BEHAVIORAL MANAGEMENT PROGRAM
Mental Health
phone(800) 711-0917Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS
Pharmacy
phone(800) 723-4337Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES
Dental Care
phone(800) 765-6003Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
  • EXPRESS SCRIPTS
Dental Care, Pharmacy
phone(800) 788-2949Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MEDIMPACT
Pharmacy
phone(800) 832-5700Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • NORTHEAST DELTA DENTAL
Dental Care
phone(800) 854-7771Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MEDI-CAL LA CARE BHA
Mental Health
phone(800) 877-7195Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • VSP
  • VSP VISION CARE
Vision (Optometry)
phone(800) 922-1557Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ESI
Pharmacy
phone(800) 932-0783Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 944-9587Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
Hospital - Inpatient
phone(800) 972-4226Eligibility / benefits, Other stated contextBenefit context: Co-Payment; Benefit context: Contact Following Entity for Eligibility or Benefit Information
  • AMERICAN SPECIALTY HEALTH
Chiropractic
phone(800) 972-8088Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
Hospital, Hospital - Inpatient
phone(800) 977-2273Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MAGELLAN
Pharmacy
phone(800) 987-8357Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS
Pharmacy
phone(800) 992-2583Eligibility / benefits, Other stated contextBenefit context: Other or Additional Payor; Benefit context: Co-Insurance; Benefit context: Co-Payment; Benefit context: Contact Following Entity for Eligibility or Benefit Information
  • ANTHEM BCBS NY
  • EMPIRE HEALTHCHOICE ASSURANCE, INC
Chiropractic, Health Benefit Plan Coverage, Hospital, Pharmacy, Professional (Physician) Visit - Office
phone(833) 267-2133Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • INGENIORX
Pharmacy
phone(833) 293-0659Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • PA AUTH CENTER
Pharmacy
phone(833) 296-5039Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CARELON RX
Pharmacy
phone(833) 396-0317Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • INGENIORX
Pharmacy
phone(833) 741-1362Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(833) 783-1448Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • RIGHTWAY RX
Pharmacy
phone(833) 848-8730Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(833) 910-4432Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Insurance
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(844) 260-5889Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(844) 306-8650Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CAPITAL RX
Pharmacy
phone(844) 387-1441Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS
Pharmacy
phone(844) 533-1995Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(844) 594-5084Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CARELONRX
Pharmacy
phone(844) 819-4773Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • COMPSYCH
Mental Health
phone(844) 852-1553Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BLUE CROSS BLUE SHIELD
Dental Care
phone(844) 895-8159Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Insurance
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Hospital - Outpatient, Pharmacy
phone(855) 271-6601Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(855) 350-1267Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CARELON RX
Pharmacy
phone(855) 453-5286Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTAQUEST
Dental Care
phone(855) 505-8110Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(855) 592-2895Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BLUE VIEW VISION
Vision (Optometry)
phone(855) 811-2218Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(866) 333-2757Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • NAVITUS
Pharmacy
phone(866) 408-6132Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Physician Visit - Office: Well, Pharmacy
phone(866) 681-8686Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • HEALTH ADVOCATE
Dental Care
phone(866) 718-2375Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BROADREACH MEDICAL RESOURCES INC
Pharmacy
phone(866) 797-9884Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(866) 805-4589Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(866) 819-4298Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SUPERIOR VISION
Vision (Optometry)
phone(866) 863-1408Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUM RX
Pharmacy
phone(866) 888-0103Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ALLEGIANT RX
Pharmacy
phone(877) 207-1357Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS (ESI)
Pharmacy
phone(877) 235-5317Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SUPERIOR VISION
Vision (Optometry)
phone(877) 241-7123Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EMPIRX
Pharmacy
phone(877) 306-3093Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EMPIRX
Pharmacy
phone(877) 449-6710Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUM BEHAVIORAL HEALTH
Mental Health
phone(877) 718-2375Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BMR
Pharmacy
phone(877) 769-7447Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(888) 202-1654Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK (CVS)
Pharmacy
phone(888) 350-3447Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CARELONRX
Pharmacy
phone(888) 352-7924Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIBERTY DENTAL
Dental Care
phone(888) 581-3648Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BLUE VIEW VISION
Vision (Optometry)
phone(888) 661-9141Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUM BEHAVIORAL HEALTH
Mental Health
phone(888) 752-7229Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CAREMARK
Pharmacy
phone(888) 790-4265Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(888) 826-8152Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTAL NETWORK OF AMERICA
Dental Care
phone(310) 214-0811Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(310) 965-1100Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(323) 317-9200Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(661) 716-8850Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Professional (Physician) Visit - Office
phone(718) 291-3434Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(800) 274-7767Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS OF CALIFORNIA
  • UTILIZATION MANAGEMENT
Chiropractic, Hospital - Outpatient, Hospital
phone(800) 305-4271Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(800) 403-4160Utilization managementBenefit context: Co-Payment; Benefit context: Limitations
  • UTILIZATION MANAGEMENT
Chiropractic
phone(800) 442-9300Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(800) 445-5747Utilization managementBenefit context: Limitations
  • UTILIZATION MANAGEMENT
Chiropractic
phone(800) 764-3433Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Hospital
phone(800) 780-8879Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(800) 832-7850Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(818) 403-2400Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(818) 461-5000Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(818) 637-2000Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(833) 442-0800Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(833) 531-6294Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(833) 951-1378Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(844) 594-5072Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic
phone(855) 343-4851Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(855) 804-0090Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 316-8438Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 438-0190Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 457-9882Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Chiropractic, Hospital - Inpatient
phone(866) 470-6244Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Hospital, Hospital - Inpatient, Hospital, Hospital - Inpatient, Hospital - Outpatient, Hospital, Hospital - Outpatient
phone(866) 678-7970Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(866) 773-2884Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • UTILIZATION MANAGEMENT
phone(866) 840-2466Utilization managementBenefit context: Limitations
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 920-1910Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 978-2029Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(877) 284-0102Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Hospital, Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(877) 450-9355Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(877) 477-3600Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(877) 499-1774Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(877) 540-6663Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(888) 322-0928Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Hospital, Professional (Physician) Visit - Office
phone(888) 620-2758Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(888) 779-7247Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Chiropractic
phone(800) 924-7141Other stated context, PharmacyBenefit context: Co-Insurance; Benefit context: Benefit Description
  • BLUECROSS AND BLUESHIELD OF TENNESSEE
  • MAGELLANRX
Hospital - Outpatient, Pharmacy
phone(855) 339-8558Behavioral health, Other stated contextBenefit context: Active Coverage; Benefit context: Coverage Basis
  • LUCET
Mental Health
phone(410) 581-3535Other stated contextBenefit context: Other or Additional Payor
  • CAREFIRST BLUE CROSS BLUE SHIELD OF MD
Health Benefit Plan Coverage
phone(800) 238-2227Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Urgent Care
phone(800) 323-2190Other stated contextBenefit context: Other or Additional Payor
  • CENTRAL STATES BLUE CROSS AND BLUE SHIELD
Health Benefit Plan Coverage
phone(800) 351-2370Other stated contextBenefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
phone(800) 392-1016Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Urgent Care
phone(800) 397-7337Other stated contextBenefit context: Co-Payment
  • AVAILITY AUTH AND REFERRALS PAGE
Hospital - Inpatient
phone(800) 424-8270Other stated contextBenefit context: Coverage Basis
  • PRIME THERAPEUTICS
phone(800) 441-2411Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Chiropractic, Urgent Care
phone(800) 452-8507Other stated contextBenefit context: Active Coverage
  • HIGHMARK MEDICAL MANAGEMENT & POLICY
Hospital
phone(800) 476-0677Other stated contextBenefit context: Non-Covered
  • SOUTHLAND NATIONAL INSURANCE CORP
Vision (Optometry)
phone(800) 521-9574Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Hospital
phone(800) 523-6435Other stated contextBenefit context: Co-Payment
  • LABLUE CLINICAL INQUIRY
Chiropractic, Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services
phone(800) 533-1120Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital
phone(800) 541-6652Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
phone(800) 553-9603Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Hospital, Hospital - Inpatient
phone(800) 627-8797Other stated contextBenefit context: Other or Additional Payor
  • ANTHEM BLUE CROSS OF CA
Health Benefit Plan Coverage
phone(800) 664-2583Other stated contextBenefit context: Active Coverage
  • HORIZON BCBSNJ
Health Benefit Plan Coverage
phone(800) 688-3828Other stated contextBenefit context: Other or Additional Payor
  • ADVANTEK
Health Benefit Plan Coverage
phone(800) 780-7881Other stated contextBenefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
phone(800) 787-4632Other stated contextBenefit context: Co-Insurance
  • VBA CARE MANAGEMENT
Hospital, Hospital - Inpatient
phone(800) 827-4814Other stated contextBenefit context: Limitations
  • MEDICAL AUDIT AND REVIEW
Hospital - Inpatient
phone(800) 828-7622Other stated contextBenefit context: Other or Additional Payor
  • CIGNA
Health Benefit Plan Coverage
phone(800) 841-2530Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Hospital
phone(800) 842-5252Other stated contextBenefit context: Other or Additional Payor
  • UNITED HEALTHCARE
Health Benefit Plan Coverage
phone(800) 845-4742Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Hospital
phone(800) 920-2485Other stated contextBenefit context: Active Coverage
  • EXCELLUS BLUE CROSS BLUE SHIELD
Health Benefit Plan Coverage
phone(800) 922-8778Other stated contextBenefit context: Co-Insurance
  • INTEGRATED HEALTH MANAGEMENT
Hospital
phone(800) 971-4153Other stated contextBenefit context: Other or Additional Payor
  • BAS HEALTHCOMP
Health Benefit Plan Coverage
phone(800) 982-8089Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM MEDICAL MANAGEMENT
  • EMPIRE MEDICAL MANAGEMENT
Hospital, Hospital - Inpatient
phone(800) 992-5498Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Urgent Care
phone(833) 447-4397Other stated contextBenefit context: Coverage Basis
  • REACH KIDNEY CARE
phone(833) 578-4436Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Urgent Care
phone(833) 578-4439Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital
phone(833) 578-4441Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(833) 592-9956Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Chiropractic
phone(833) 647-9355Other stated contextBenefit context: Co-Insurance
  • MONTEFIORE CARE MANAGEMENT ORGANIZA
  • MONTEFIORE CMO 833-MHS-WELL
Hospital
phone(833) 663-8703Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible; Benefit context: Coverage Basis
  • CREDENCE BCBS
  • PA LOGIC SOLUTIONS
Hospital
phone(833) 772-4122Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(833) 798-6733Other stated contextBenefit context: Coverage Basis
  • BCBSAL
phone(833) 800-4032Other stated contextBenefit context: Coverage Basis
  • BCBSAL
phone(833) 800-4033Other stated contextBenefit context: Coverage Basis
  • BCBSAL
phone(833) 953-1754Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(844) 235-4454Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • EMPIRE MEDICAL MANAGEMENT
Chiropractic, Hospital, Hospital - Inpatient
phone(844) 235-4455Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • EMPIRE MEDICAL MANAGEMENT
Chiropractic, Hospital, Hospital, Hospital - Inpatient
phone(844) 241-7085Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Hospital
phone(844) 241-7087Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS
  • ANTHEM BLUE CROSS AND BLUE SHIELD
  • EMPIRE MEDICAL MANAGEMENT
Chiropractic, Hospital, Hospital, Hospital - Inpatient, Hospital, Hospital - Inpatient, Hospital - Outpatient, Urgent Care
phone(844) 647-3693Other stated contextBenefit context: Co-Insurance
  • EMPIRE MEDICAL MANAGEMENT
Chiropractic
phone(844) 827-9211Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Urgent Care
phone(855) 243-3326Other stated contextBenefit context: Co-Payment
  • SLEEP MANAGEMENT SOLUTIONS
Hospital - Inpatient
phone(855) 333-5730Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS OF CALIFORNIA
Hospital, Hospital, Hospital - Inpatient
phone(866) 205-5107Other stated contextBenefit context: Coverage Basis
  • PA LOGIC SOLUTIONS
phone(866) 251-1689Other stated contextBenefit context: Other or Additional Payor
  • ANTHEM BLUE CROSS BLUE SHIELD
Health Benefit Plan Coverage
phone(866) 803-8002Other stated contextBenefit context: Coverage Basis
  • CARELON MEDICAL BENEFITS MANAGEMENT
  • EVICORE HEALTHCARE
phone(877) 233-1800Other stated contextBenefit context: Other or Additional Payor
  • UMR
Health Benefit Plan Coverage
phone(877) 288-0719Other stated contextBenefit context: Coverage Basis
  • HEALTH EQUITY
phone(877) 324-2990Other stated contextBenefit context: Co-Insurance
  • QUANTUM HEALTH
Hospital
phone(877) 392-9865Other stated contextBenefit context: Other or Additional Payor
  • MEDICARE PART A & PART B COVERAGE
Health Benefit Plan Coverage
phone(877) 430-2288Other stated contextBenefit context: Co-Payment
  • CARELON
Hospital
phone(877) 535-2128Other stated contextBenefit context: Other or Additional Payor
  • AETNA
Health Benefit Plan Coverage
phone(877) 811-3106Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(800) 214-4844
  • ANTHEM
phone(800) 238-8379
  • ANTHEM
phone(800) 327-6716
  • ANTHEM
phone(800) 727-2227
  • ANTHEM
phone(877) 444-2374
  • ANTHEM
phone(888) 233-8351
  • ANTHEM

Phone and fax numbers sourced directly from the payer response

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services — including claims affected by the 2027 CPT code revisions — providers should consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.