The Anthem Network

Join Our Network

Welcome!

If you are a non-contracted provider and would like to join Anthem’s network, please complete the Indiana Provider Maintenance Form online.This form is for physicians, providers, professionals and ancillary providers to apply for participation with Anthem Blue Cross and Blue Shield in Indiana. The information provided will be used to determine contract eligibility and to draft legal documents for signatures as needed.

If you are already contracted with Anthem and are interested in participating in additional networks, please contact your Provider Contract Specialist via the Territory Grid. If you require a Tax Identification Number change, please complete the Indiana Provider Maintenance Form.

Page Last Updated: 04/01/17