Anthem Provider Credentialing Services

Anthem uses credentialing to screen and choose licensed independent practitioners to provide care to our members. Anthem uses the Council for Affordable Quality Healthcare (CAQH) ProView tool for certification. This private and secure portal reduces the amount of paperwork needed to complete the credentialing process.

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How Will Our Experts Assist You During The Process?

We will examine your educational background, employment history, credentials, and registration to practice in a healthcare sector during the credentialing step. We will monitor your progress through the credentialing process to analyses your education, training history, credentials, and registration to practice in a health care setting. We will go over all of your paperwork so that you can be certified at one of the greatest healthcare providers in the USA. As a team, we are devoted to long-term growth. We will help you obtain the services you desire. This is how we show our clients how much we appreciate them and strive to provide excellent customer service.

What We Do To Help You

  • It will save you months of time and effort
  • Removes aches and pains produced by large numbers of printed materials and applications
  • Boosts patient referrals
  • Insurance firms pay out more quickly
  • Assigns a project manager to your venture
  • Makes phone calls, follows up on them, and presents all applications, texts, and emails
  • Access to online project portals is available at all times
  • Give you a cost-competitive advantage to help your practice expand

What Information is Necessary for Credentialing?

The information varies according to the payer, however, it is generally consistent across the board and normally includes.

  • A History of Malpractice Claims
  • Suspensions and Revocations
  • Practice License and Main Source Verification
  • Unique Identifier (NPI)
  • Previous Licenses
  • DEA Certification
  • Job Experience
  • Diplomas and Transcripts
  • Prior Employer/Practitioner References
  • Information on Insurance
  • Board of Examiners Certification

Criteria for Credentialing

All health care practitioners must achieve the following criteria within the context of the Anthem Credentialing Program to be eligible for initial participation in Anthem programs or networks:

Submission of a complete application and any necessary additions, which must not contain any intentional misstatements

The date of certificate attestation must be confirmed within 180 calendar days of the date of submission to the CC for a vote

There is no ongoing license activity in any state; and there is no history of licensing committee action in any state

Confirmation of primary references within reasonable times

There is no indication of any potential major omission(s) on the form


The re-credentialing process includes re-verification and the Identification of differences in the practitioners or HDO’s

  • Licensure
  • Certification
  • Health status
  • The performance data (including, but not limited to, negligence

Experience, hospital right or other actions) that may indicate on the Practitioner’s or HDO’s professional conduct and support All applicable practitioners and HDOs in the network within the range of Anthem Credentialing Program is expected to be credentialed every three years unless asked by agreement or state laws.

Phone number for Anthem Credentialing

If you have any contract questions, please call KY National Provider Solutions (NPS) at 800-205-5870.

Application for Anthem Enrollment

You will be directed to submit an online application with all of your previously obtained credentials. Every entity you enter will be scrutinized and validated. It contains a number of identifying prerequisite options for rating and validating your credibility. As a result, they will double-check all of your information and keep you updated on the status of your ongoing procedures and progress at Anthem Enrollment


Anthem provider credentialing is the process by which Anthem verifies the qualifications
and experience of healthcare providers who want to participate in their networks. This
process helps to ensure that Anthem members have access to high-quality care from
qualified providers in the USA.

Anthem provider credentialing is important because it helps to protect Anthem members
from receiving care from unqualified healthcare professionals. It also helps to ensure
that Anthem is paying healthcare professionals fairly for the services they provide to their
patients or anthem members in the USA.

Any healthcare provider who wants to participate in an Anthem network needs to be
credentialed. This includes physicians, dentists, nurses practitioners, and other
healthcare professionals in all those states of the country where Anthem provide its

We have an expert Anthem credentialing team; our medical credentialing expert
complete the Anthem credentialing process from start to final complete enrollment. The
main steps in the Anthem credentialing process are:
1. Stars Pro credentialing experts completes an application and submits it to
2. Anthem team verifies the provider's education, training, and experience
submitted by our team.
3. Anthem team checks the provider's licensure and malpractice history.
4. It is not compulsory but some time Anthem may also conduct a site visit to the
provider's office.
5. Once the credentialing process is completed, Anthem will notify Stars Pro about
provider credentialing status.

We have an expert Anthem credentialing team and our team will complete the whole
credentialing process, while the Anthem typically takes 60-90 days to complete the
enrollment process. However, it may take longer if Anthem has any questions or
concerns about the provider's application for the enrollment process.

1. Access to a large network of Anthem members.

2. Competitive reimbursement rates.
3. A streamlined credentialing process.
4. Support from a team of experienced credentialing specialists.

To apply to be credentialed by Anthem, you can fill the form on our website, our
credentialing experts will call you within 24 hours. You can also call our Anthem
Provider Credentialing team at 1-732-523-4633 for more information.

The process of maintaining your Anthem credentialing is simple, you must:
1. Keep your license and malpractice insurance up to date, if you have question you
can call stars Pro credentialing team any time at 1-732-523-4633.
2. Report any changes to your healthcare practice, such as a new address or
phone number.
3. Complete any required continuing education and inform to our team.
4. Cooperate with Anthem credentialing audits to avoid future problems.

If you have any questions about the Anthem provider credentialing process, you
can contact Stars Pro Anthem Provider Credentialing team at 1-732-523-4633.

Some common mistakes that providers make when applying for Anthem
credentialing by own include:
1. Healthcare professionals are submitting the application without completing the
application accurately and completely.
2. Providers are not submitting all of the required documentation on time.
3. Providers are not responding to Anthem's requests for information promptly.
4. Providers are not updating their contact information with Anthem.

Channel Partners

Stars Pro® Medical Billing inventive model is one of the fastest growing physician practice communities in the United States. We are dedicated to lashing change in the medical community by providing progressive, state-of-the-art solutions. Through our Channel Partnerships.


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