Escalation Contact List - Anthem

Anthem Blue Cross and Blue ShieldEscalation Contact List – Colorado ProvidersBlueCard/National Provider Customer Service 888-817-3717• All inquiries related to claims payment must be directed to Anthem’s self-service tools or Provider/Customer Service.• In the event that our self service tools and Provider/Customer Service rep are unable to provide you with the support you need, you may request to speak witha Provider/Customer Service supervisor and your call will be escalated. If a supervisor is unable to assist you immediately, you will receive a call back within 2business days.Note: An issue cannot be escalated without a reference number from Provider/Customer ServiceLocal and IntraPlan (CA Anthem Blue Cross and NV Plan members) Provider Customer Service 877-833-5742• All inquiries related to claims payment must be directed to Anthem’s self-service tools or Provider/Customer Service.• In the event that our self service tools and Provider/Customer Service rep are unable to provide you with the support you need, you may request to speak witha Provider/Customer Service supervisor and your call will be escalated. If a supervisor is unable to assist you immediately, you will receive a call back within 2business days.Note: An issue cannot be escalated without a reference number from Provider/Customer ServiceFederal Employee Program Provider Customer Service 800-852-5957Melissa Holland Operations Expert 775-448-4152 Melissa.holland@wellpoint.comMarcia Hornbuckle Operations Expert 775-448-4192, Marcia.Hornbuckle@Anthem.comMarlene Fogel Manager, Provider Customer Service 775-448-4059, Marlene.Fogel@Anthem.comAnthem Dental 866-947-9398 (FEP Dental 805-713-4815)Anthem Vision 866-723-0515Credentialing To check credentialing status of a new provider, Please have the following information ready toinclude with your inquiry: Your name, Provider’s name, CAQH ID number, and reason for inquiryCredentialing@wellpoint.com,800-516-7587Cost Containment Unit (for Local Plan, BlueCard or FEP) 303-861-1449Cost Containment Unit Team Unit dedicated to overpayments to assist with; overpayment issues resulting from overpayment letters, balancing 303-861-1449books when “clipping” (or a take back) has occurred, or, asking for extension on “clipping” when sending in arefund check.Dean Scully Manager, Financial Operations Department 818-234-5840, Dean.Scully@wellpoint.comPre-certification/Authorizations 800-832-7850Landon Mikuls Operations Team Lead 805-713-0818, Landon.Mikuls@Anthem.comProviderAccess Registration and Support (secure provider portal)see belowProviderAccess Support for ProviderAccess registration process or Account Administrator changes: for provideraccesswest@anthem.comRegistrationAccount Administrator support only (user’s please see your Account Administrator)Ignacio AdalinTeam Lead, ProviderAccess registration process or Account Administrator changesIgnacioJr.Adalin@wellpoint.comissue/concern. For Account Administrator support only (user’s please see your Acct. Admin)Cherry Francisco Manager, ProviderAccess registration process or Account Administrator changesCherry.Francisco@wellpoint.comissue/concern. For Account Administrator support only (user’s please see your Acct. Admin)ProviderAccess Once registered, the ProviderAccess Support Team provides technical support for866-755-2680Support Teamutilizing portal tools, password resets, or issues that arise while accessing the portalNote: Your Account Administrator (AA) is responsible for creating users/updating user profiles. If you don’t know who your AA is, follow the ProviderAccessRegistration process and complete Step 1. You will receive a message stating your organization is already registered, including the name of your AA.EDI (electronic submissions) 800-332-7575EDI Solutions Team Supports enrollment for all HIPAA transactions 837, 835, 270/271, 276/277, 278,800-332-7575834 and EFT. Support for technical questions regarding EDI transactions.Cathy Lewis EDI Operations Manager 502-889-4559, Cathy.Lewis@Anthem.comColorado Medical Directors – Backline (FEP or BlueCard issues/inquiries need to be directed to FEP or the Member’s Home Plan.) 888-236-2984For Local Plan memberissues.Choose which medical director you want to speak to, and your call will transfer directly to hisor her direct line. If the medical director isn’t available, leave a message and your call will beFax: 303-831-2930Fax: 866-306-0543Intended For Providers orOffice Staff onlyreturned as soon as possible (usually within 24 hours.)To schedule DOI-regulated UM discussions, continue to use the existing number, 303-764-7227 (1-866-287-1654 toll free).Provider Engagement and Contracting Team Toll Free – 800-570-8105, plus ext. below, Fax: 303-831-5833Provider Relations: contact for demographic updates, credentialing inquiries, or provider education questions/needsGayle Burstein Northern Colorado and Denver metro area including: Arvada, Bailey, Boulder, Broomfield, Conifer,Denver, Englewood, Ft. Collins, Glendale, Golden, Greeley, Greenwood Village, Highlands Ranch,Lafayette, Lakewood, Littleton, Louisville, Loveland, Morrison, Steamboat Spgs, Westminster, Wheat RidgeLolly EsquibelCentura Physicians, plus; Colorado Springs, Pueblo and Denver metro area including:Aurora, Brighton, Castle Rock, Commerce City, Dupont, Evergreen, Franktown, Glenwood Springs,Grand Junction, Gunnison, Lone Tree, Montrose, Northglenn, Parker, Superior, Thornton, Vail303-831-2462Gayle.Burstein@anthem.com303-831-2513Lolly.Esquibel@anthem.comMelissa Hayden Exempla, HealthONE, MedSouth, National Jewish, Rose Medical Group, Physician Health Partners(PHP), plus; Durango and Southern Colorado (except Colorado Springs and Pueblo)805-713-8773, fax: 877-215-9763Melissa.Hayden@anthem.comTania Sundheim Director, Network Management 303-831-2154, Tania.Sundheim@Anthem.comProvider Contracting: contact for contract inquiriesRevised: February 20, 2013 Page 1 of 2Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc.Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of theBlue Cross and Blue Shield Association.

Tania Sundheim Director, Network Management (Physician, Behavioral Health and Hospital) 303-831-2154, Tania.Sundheim@Anthem.comPhysician Contracting(Large Medical Groups and state-wide Specialties)Karen AllenMedSouth; plus,303-831-2436, Karen.K.Allen@Anthem.comCarolyn Gonzales-SmithInfectious Disease, Oral-Maxillo Surgery (state-wide)Arapahoe GI, Aurora Denver Cardiology, Centura Physicians, Colorado Springs Health Partners,Colorado Springs Orthopedics, Gastroenterology of the Rockies, HealthONE Clinic Services, IPN,Longmont Clinic, Mountain View Medical Group, New West Physicians, OB/GYN Affiliates, Omni EyeSpecialists, Panorama Orthopedics, Physician Health Partners (PHP), Pikes Peak Cardiology, RockyMountain Gastroenterology Assoc., South Denver Gastroenterology, The Urology Center ofColorado, University Physicians, Inc., Western Cardiology, Western Orthopedics303-831-2607Carolyn.Gonzales@Anthem.comZanetta Jackson Autism Network, Rheumatology (state-wide) 303-831-2764, Zanetta.Jackson@Anthem.comAudra RickeAssociates in Family Medicine, Banner, Boulder Medical Center, Exempla, Family Physicians ofGreeley, Ft. Collins Women’s Clinic, Greeley Medical Center, Orthopedic Center of the Rockies,Northern CO IPA, Poudre Valley Health Systems, Poudre Valley Medical Group, Rocky MountainCancer Center, Rose Medical Group, Southern Colorado Clinic, Valley Wide; plus,Neuromonitoring network (state-wide)303-831-3140Audra.Ricke@Anthem.comAmy Sun Hospital based: Anesthesia, Emergency Room, Pathology, Radiology (state-wide) 303-831-2461, Amy.Sun@Anthem.comPhysician Contracting by City(excluding Large Medical Groups and statewide specialties listed above, and Behavioral Health professionals listed below)Karen AllenZanetta JacksonAurora, Canon City, Castle Rock, Centennial, Colorado Springs, Denver, Englewood, Franktown,Glendale, Greenwood Village, Highlands Ranch, Kittridge, Lakewood, Littleton, Lone Tree, Morrison,Parker, Pueblo, Rocky Ford, Salida, TrinidadArvada, Boulder, Brighton, Broomfield, Commerce City, Craig, Fort Collins, Golden, Greeley, IdahoSprings, Lafayette, Longmont, Louisville, Loveland, Niwot, Northglenn, Steamboat Springs, Sterling,Superior, Thornton, Westminster, Wheat Ridge303-831-2436Karen.K.Allen@Anthem.com303-831-2764Zanetta.Jackson@Anthem.comJan McCusker Cortez, Durango, Pagosa Springs 303-831-3204Jan.McCusker@Anthem.comAudra RickeBailey, Conifer, Evergreen, Glenwood Springs, Grand Junction, Gunnison, Leadville, Montrose, Pine,Telluride, Vail (Edwards)303-831-3140Audra.Ricke@Anthem.comBehavioral Health Professional Contracting by CityItha Gabriel Denver, Colorado Springs (all other cities, see Physician Contracting by City category listed above) 800-962-1037 opt. 2Hospital ContractingTracy FennernBanner Health System, Centura Health System, Children’s, Longmont United, Poudre ValleyHospital, Medical Center of Rockies, Platte Valley Medical Center, LTACs and Rehab Hospitals303-831-3299Tracy.Fennern@Anthem.comItha Gabriel Behavioral Health facilities 800-962-1037 opt. 2Randy LukinsHealthOne (HCA), Exempla, Craig Hospital, Denver Health, National Jewish, University Hospital, freestanding radiology centers (Denver Metro), Radiology Imaging Assoc.916-636-2351Randy.Lukins@wellpoint.comJan McCuskerSouthern Colorado and Grand Junction; plus, Conejos County Hospital, Memorial Health System,The Memorial Hospital at Craig, Parkview Medical Center, Rio Grande Hospital, San Luis ValleyRegional Medical Center;303-831-3204Jan.McCusker@Anthem.comAmy SunBoulder Community Hospital, Haxtun Hospital District, Kremmling Memorial Hospital Dist., St.Vincent General Hospital Dist., Vail Valley Medical Center, Valley View, Weisbrod Memorial CountyHospital, Wray Community Dist. Hospital, Yampa Valley Medical Center, Yuma Dist. Hospital,Diversified Radiology and Colorado Imaging Assoc.303-831-2461Amy.Sun@Anthem.comAncillary ContractingNatasha BakerAmbulance (Ground and Air), Ambulatory Cardiac Event Monitoring,303-831-3058, Natasha.Baker@anthem.comAudiologists/hearing aid suppliers, PT/OT/STKathleen Brozee Skilled Nursing Facilities 818-234-3399, Kathleen.Brozee@wellpoint.comLandmark Healthcare Chiropractic, Acupuncture, Massage Therapist, Nutritionists/dieticiansNote: Provider demographic changes and provider administrative grievances shouldbe directed to LandmarkLandmark Healthcare: 800-638-4557Louis Carlentine Durable Medical Equipment (DME), Mail Order Disposable Supplies, Orthotics & 818-234-6266, Louis.Carlentine@wellpoint.comProsthetics (O&P), Reference LabMarie Chambers Home Health, Hospice 949-215-1165, Marie.Chambers@wellpoint.comAudra Ricke Free standing sleep centers 303-831-3140, Audra.Ricke@Anthem.comAmy SunASCs (for hospital-affiliated ASCs, contact appropriate contractor for that Hospital303-831-2461, Amy.Sun@Anthem.comlisted above under “Hospital Contracting”)Sandra Whitfield Dialysis, Home Infusion Therapy (HIT), Ambulatory Infusion Suites (AIS), Medical 303-831-3249, Sandra.Whitfield@Anthem.comSpecialty PharmacyProvider Education and Communication: contact for provider education/communication questions/needsJackie Ferguson Network Education and Communication 303-831-5846, Jackie.Ferguson@Anthem.comRevised: February 20, 2013 Page 2 of 2Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc.Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of theBlue Cross and Blue Shield Association.