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Anthem fax number

(888) 562-5165

HIP Member Authorization

Used for: Submitting HIP member authorization/disclosure forms for the Healthy Indiana Plan (HIP)

Fax destination details

Department
HIP Member Authorization
Purpose
Submitting HIP member authorization/disclosure forms for the Healthy Indiana Plan (HIP)
Form
HIP member authorization form — HIP Member Authorization Form
Address
PO Box 62509, Virginia Beach, VA 23466

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Submit signed HIP member authorization forms to Anthem's Member Privacy Unit. Fax: 888-562-5165. Mail to Anthem’s HIP Member Privacy Unit, PO Box 62509, Virginia Beach, VA 23466.

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