Provider Change Form: Online form providers use to update information. NPI, address, or phone), please submit the Provider Change Form found below. If you are an existing myNEXUS Participating Provider and need to update any of your Provider Information (i.e. Please contact the myNEXUS Claims Team for questions related to the claims process by calling 83. To enroll in the EFT program, please register for EFT payments by completing the online application form:Ĭlaims Forms: Claims Appeal Form for In-Network Providers Claims Appeal Form for Out of Network ProvidersĬlaims Waiver of Liability Form for Out of Network ProvidersĬlaims Notices: NOA Notice: Effective January 1st, 2022 HIPPS Code Notice: Effective April 15th, 2020 RAP Claim Notice: Effective January 1st, 2021 Please find important forms related to the myNEXUS Claims Process listed below.Įlectronic Funds Transfer (EFT) Enrollment: myNEXUS offers EFT payment options for providers. The myNEXUS payer ID for the Anthem delegation is: 34009. This document explains the IV therapy program in detail. Home Infusion (IV) Therapy: Home Infusion (IV) Therapy Information:myNEXUS is not delegated for IV Therapy. Re-Authorization Request Form:Fax form to use for re-authorization requests if needed.įax Confirmation Form: Online Form providers use to confirm their fax numbers for authorization requests. Initial Authorization Request Form:Fax form to use for initial authorization requests if needed. The Provider Portal can be found online here. Please note Risk plans are not included in this delegation.Īuthorization Requests: myNEXUS Provider Portal: myNEXUS encourages providers to utilize the online Provider Portal to submit authorization requests. In-Scope Plans: In-Scope Plan List:The list of in-scope Anthem plans for the myNEXUS delegation listed by state. Please complete the “Agency Information Form” to have your agency’s information added to the myNEXUS system. Contracting: To become a myNEXUS contracted provider, please complete the form found online here.Orientation Sessions: Please register for an orientation training session online here.Notice: The delegation notice and orientation letter mailed and emailed to agencies is available here.Delegated services include Utilization Management, Network Management, and Claims Reimbursement. Delegation: Effective March 1st, 2023, myNEXUS will manage Amerigroup Medicare Advantage (MA) plans in the state of New Jersey.Current Announcements: New Jersey | March 1st, 2023 Delegation Information: Please find important announcements, documents, and forms listed below. to provide utilization management for home health services. MyNEXUS is proud to announce its partnership with Anthem, Inc.
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