Marlien · Payer guide
Anthem Blue Cross Blue Shield of Georgia
Elevance Health — Anthem Blue Cross Blue Shield GA, Inc.
- GA
- Commercial
- Marketplace (ambetter is separate — Centene)
- SHBP
Where you file
- How you apply
- Availity Digital Provider Enrollment
- The path
- Payer Spaces › Anthem › Applications › Provider Enrollment
- What access you need
- A "Provider Enrollment" role must be assigned to the user filing.
- Who verifies
- Elevance performs its own PSV (no CVO)
- Worth knowing
- DPE is available for PROFESSIONAL PRACTITIONERS ONLY. It pulls professional and practice details from CAQH ProView to populate the file. Electronically submit ALL credentialing documents — the Availity trading-partner obligation does not accept paper.
CAQH
- Required
- Complete profile → upload documents → attest → authorize Anthem. All three are separate steps.
- Authorise this payer
- Anthem Blue Cross Blue Shield of Georgia
Lines of business
Each line is its own application, with its own checklist, its own effective date and its own contract. Filing one does not file the others. What follows is what this payer asks for, line by line.
Commercial
Anthem Blue Cross Blue Shield Georgia commercial book. Filing path: Availity DPE → Anthem › Applications › Provider Enrollment.
Medicare Advantage (MA)Medicare Advantage
Anthem Medicare is a SEPARATE contract and credentialing file with its own Medicare authorization. Backdating under 42 CFR 424.521 may apply.
Marketplace (Anthem only)
Ambetter in Georgia is Centene's, not Anthem's — do not file Ambetter here.
State Health Benefit Plan
PEHP admin services. Public Employees Health Benefit Program — a Georgia state plan, not a commercial product.
What the payer publishes about time
- Completeness review
- notVerified
- Decision
- 45 days from a completed CAQH application
- Committee
- notVerified — no cadence or SLA published for GA commercial; plan against the end-to-end 45 days
- Contract
- notVerified
- What the numbers mean
- The published 45-day figure comes from the Join Our Network page, not the provider manual.
Deadlines that start a clock
Notify material change10 calendar days
counted from the effective date
Recredentialing
- Cycle
- 3 years
- What it hangs on
- CAQH cycle
- Worth knowing
- If CAQH is current and complete there is no additional effort. If the attestation is expired or data incomplete, the application is incomplete and the provider faces administrative termination from the network.
The effective date
Approval is not the date. These are the markers that make a date real.
- How it is established
- Assigned at provider setup; provider record and directory populated.
- What proves it
- Provider record + directory listing
- Worth knowing
- Commercial only. Anthem's Medicare Advantage line is a SEPARATE contract and credentialing file.
Backdating: 30 days
42 CFR 424.521(a)(1) — retrospective billing is permitted for up to 30 days before the effective date ONLY where circumstances precluded enrollment in advance of providing services, and only for services provided at the ENROLLED PRACTICE LOCATION. 90 days is available where a Presidentially-declared Stafford Act disaster precluded advance enrollment. It is a DETERMINATION, not an entitlement.
Federal rule, not confirmed in Anthem's own MA material. The MA line is a SEPARATE contract and credentialing file.
This is a federal rule. This payer's own material does not confirm it, so we do not promise it. We tell the payer what the circumstances were and let the payer decide.
What we checked, and what we did not
Channel, DPE path, DPE professional-practitioner-only scope, CAQH requirement, 45-day figure, 3-year cycle, PDM maintenance path and all four links confirmed 2026-11-02. Committee cadence, stage SLAs and appeal window NOT verified.
The payer's own pages
Where to file
- Availity — Digital Provider Enrollment (start here)Log in → Payer Spaces › Anthem › Applications › Provider EnrollmentRequires an Availity org admin and a "Provider Enrollment" role on your user.
- CAQH / DataSpring — authorize Anthem BCBS GAProView › Authorization tab › add Anthem Blue Cross Blue Shield of GeorgiaProfile, documents, attestation and authorization are four separate steps.
- Availity registrationRegister the organization first, then the individual usersAvaility Client Services: 1-800-AVAILITY (282-4548).
Information and forms
- Anthem GA — Availity digital solutions pageThe Georgia-specific page that confirms Availity as Anthem's EDI partner.
- Anthem GA Facility & Professional Provider Manual (eff. 2025-01-01)The single most useful GA document. Section "Provider Participation" describes DPE.
- Provider maintenance / demographic updates (GA)Contracted providers use Availity PDM. Non-participating providers use the NonPar Update Form.
- Anthem provider contact pageProvider Services 800-676-BLUE (2583).
Who to contact
- Anthem Provider ServicesGeneral provider assistance800-676-BLUE (2583)
- Availity Client ServicesPortal access and role assignment1-800-AVAILITY (282-4548)Mon–Fri 8 a.m.–7 p.m. ET.
- Provider Relationship ManagerAssigned by Anthem after you enter the networkThe named owner for a practice. Not published — ask Anthem to assign one.