Follow the steps below to register as an out-of-network practitioner with Anthem BCBS NY:
1. To register as an out of network practitioner, you will first need to create a free Availity Essentials account here.
2. Once registered with Availity, change the state to New York.
3. Select my “My Providers”, then “Provider Data Management”
4. You’ll then be directed to this page. Select “Search and Add” to add your information and begin the process of registering as an out of network practitioner.
5. Once your information has been added, you will be directed to this page where you will complete and fill out all the necessary information under each step.
6. Step 2 will request W-9 documentation. Click “add a W-9” to upload a copy of your W9, including the written cover letter of request for your address to be added under the tax ID. If you need assistance obtaining a W9 and cover letter, you can fill out this form and request a copy from our Customer Care team.
7. Once all information has been completed, select Save and then Submit Verified Profile.