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CHANGE EXISTING PROVIDER ENROLLMENT INFORMATION

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Request for Additional Information

While processing the application(s) National Government Services may determine additional information is needed.

All requested information should be submitted as soon as possible, but no later than 30 days from the initial development letter date or claims payment may be impacted.

    • The contact person (identified on application) will either receive an email, fax or USPS mail that will include the instructions for needed actions, corrections and required documents. The email will display from the sender PEDoNotReply@anthem.com.

The contact person should be on the lookout for emails and routinely verify spam or junk email folders. Add “PEDoNotReply@anthem.com” address to your safe senders list.

Request for Additional Information
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