Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. Pharmacy Information for Providers We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. 1-888-803-4960 1-877-258-0167 Lets make healthy happen. Just keep in mind you'll need to go through the prompts before you're connected to someone. Get access to your online account. endobj We also offer infusion services with Optum Infusion Pharmacy. Box 33248 There is no cost for this service. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play. It can also send you a copy of your claim's status. We promise to always deliver simple ways to get the medication you need. 1-800-249-5103 Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. We offer affordable health, dental, and vision coverage to fit your budget. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. Register Now, Learn more about registering for our web tools. If your state isn't listed, check out bcbs.com to find coverage in your area. 1-844-876-7917 You can find yours by selecting your region: Not sure which region you're in? Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. Compare plans available in your area and apply today. Behavioral health services for Blue Cross Blue Shield of Michigan are managed by New Directions. Medicare Plus BlueSM PPO services are managed by Medicare Plus Blue Behavioral Health. Medical and pharmacy strategies complement each other; theyre based on the same goals. Box 230589 Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Step 6:Tell the system the total amount charged. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. Explore our comprehensive guides and video resources for more information regarding your condition. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Medicaid renewals are starting. Birmingham, AL 35238-0518. We send members personalized messages about medications that may reduce their costs and include specific cost savings. Verify patient eligibility and benefits Essential Vision providerssubmit claims throughHeritage Vision Plan. There's no more critical person on this team than you, the provider. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. You can also use these documents for guidance: Have your NPI, Tax ID or Social Security number ready before calling. Providers who are not Designated SRx Network providers will be required to acquire the select specialty pharmacy medications administered in the office or the hospital outpatient setting through CVS Specialty Pharmacy. If you need additional guidance, read the Dentaquest Dental Manual (PDF). Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2023. Our resources vary by state. Physicians and professionals: 1-800-344-8525 Large Group Available for iOS and Android devices. Provider Inquiry Mail Code 0301 These pharmacies serve members with complex or chronic conditions. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: Manage your medicine from anywhere with the Anthem mobile app With the free app, you can: Order refills Track orders View all prescriptions Download the app now: Page Last Updated: 06/09/21 Lansing, MI 48933. Detroit, MI 48232-4248, Provider Inquiry P.O. Hospitals or facilities: 1-800-249-5103. Search for specific text by using your Find function (Ctrl+F or Command+F). If a medication is selected that is not on the drug list, the member will be responsible for the full cost of the drug. Say "claims" when the system asks why you're calling. Important informationabout your 1095-B form. One Woodward Avenue, Suite 2020 In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Jun 1, 2020 Automated information is available anytime. Not sure which region you're in? You can also talk to your provider consultant. Both medical and pharmacy costs are our responsibility. The purpose of this communication is the solicitation of insurance. Detroit, MI 48231-0166, Federal Employee Program claims From easy online refills to one-on-one CareTeam support from specially trained nurses and pharmacists, we give patients the care they need, when and where they need it. What you need to know about the coronavirus, COVID-19. The list of specialty pharmacy medications subject to the above will be posted on anthem.com for reference and is subject to change. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). The automated system is available anytime. In Ohio: Community Insurance Company. L07B Products & Programs / Pharmacy. State and Federal Privacy laws prohibit unauthorized access to Member's private information. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Contact will be made by an insurance agent or insurance company. Our goal is to help improve your patients health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and knowledge. CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. This applies to members with Preferred Provider Organization (PPO), HealthKeepers (HMO), POS AdvantageOne, and Act Wise (CDH plans). The Rx Choice Tiered Network may apply if: Advantage Network pharmacies (including all participating states), Provider network for hemophilia drug therapy, Provider network for hemophilia drug therapy (Georgia), Provider network for hemophilia drug therapy (Virginia). When you're contracted with us you have access to a provider consultant. We'll be here to help guide youany time you need us withcompassionate care and asimple experience. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. Submit prior authorization requestselectronicallythrough CoverMyMeds. The notice states that the requirement applies to Anthem's commercial HMO effective with July 1, 2020, dates of service . As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. Monday through Friday. PO Box 385018 8 a.m. to 5 p.m. National Accounts, Posts about using health Insurance and managing your health, Collections of learning resources and links to services, For Sydney Health users connect with others and find care programs, An Important Message for Members receiving care from Advanced Infusion Solutions (AIS). We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. Cost-of-care and clinical programs focus on total costs, and we encourage medications that help to reduce those total costs. A specialty pharmacy does more than just fill prescriptions. Note:It can take up to 30 days for a claim to be processed. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. IngenioRx is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. The Prior Authorization process allows for the request and approval of these medications. CVS Specialty and Hemophilia Treatment Centers on the list are considered in-network and will give you lower costs for your Factor treatment under the medical benefit. Box 7355 Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? When you email us, we'll call . If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. You can write to us by finding your area code with the relevant mailing address. Please refer to the preferred drug list (PDL) when prescribing for these members. Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. Medicare Complaints, Grievances & Appeals. 1-855-504-2583 We encourage medications that improve patient health. Call our Customer Service number, (TTY: 711). Whether you need to check on a claim, pay a bill, or talk to a representative, you can easily access all your member features. Plus, you may qualify for financial help to lower your health coverage costs. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. Box 2227 If you call before 30 days, we may not be able to check your claim through our automated phone system. Monday through Friday TTY users: To reach any number listed here, dial 711. P.O. Specialty Pharmacy Benefits | Anthem Blue Cross Blue Shield Nevada Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. We currently don't offer resources in your area, but you can select an option below to see information for that state. You can order by phone whether or not you're already a member. Mar 10, 2023 05:00pm. This applies to all Anthem Indiana commercial members. These pharmacies serve members with complex or chronic conditions. Look for these symbols in the pharmacy listings: Pharmacy search tips: Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and knowledge. We look forward to working with you to provide quality service for our members. We see how drugs work in our members real lives and help them make good health care choices. Vision and hearing providers: 1-800-482-4047. <> In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. You get your health insurance plan from an employer or if you have certain grandfathered plans. Review medical and pharmacy benefits for up to three years. Medication is often one of them. Members dont receive multiple letters focused on individual clinical and cost-of-care programs. Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. If you have questions, please contact your group administrator or your Anthem network representative. CVS Specialty makes living with your condition easier. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Members should talk with their doctor about prescribing a drug that is on the drug list. Blue Vision providers submit claims electronically directly toVSP. We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. You'll need to use e-referral for Medicare Plus Blue authorization requests. Help for members impacted by the winter storms emergency in California, March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, June 2020 Anthem Blue Cross Provider News - California, Monday through Friday from 5 a.m. to 7:30 p.m. Pacific Time, Saturday from 6 a.m. to 10 a.m. Pacific Time. Our automated interactive voice response system provides claims, benefit and cost-share information. If youre a professional provider office, you have access to a provider consultant. 8 a.m. to 7 p.m. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Some drugs, and certain quantities of some drugs, require an approval before they are eligible for coverage. 8 a.m. to noon and 1 to 5 p.m. Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. We look at claims data to find opportunities for our members to save money by switching them to lower-cost, therapeutically equivalent drugs. All specialty pharmacy prior authorization requirements will still apply and are the responsibility of the ordering provider. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. 3 0 obj Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. Monday through Friday Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Products & Programs / Pharmacy. stream Health equity means that everyone has the chance to be their healthiest. 8 a.m. to noon and 1 to 5 p.m. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. If youre an administrative office of a medical care group, you have access to a professional organization consultant. You can use our automated system to reach a representative to discuss your claim's outcome. Search for specific text by using your Find function (Ctrl+F or Command+F). Once we identify a gap in care, the member receives a personalized Medication Review, which contains pharmacy messaging for our clinical and cost-of-care programs in one consolidated, health plan-branded, monthly member communication. There's no more critical person on this team than you, the provider. Monday through Friday, Care Management--Mail Code C355 With the Rx Choice Network, you can choose from two levels of coverage, helping to provide both savings and access: Level 1: You can get prescriptions filled at Level 1 pharmacies for the same copay or percentage of the drug costs you usually pay as part of your prescription drug plan. Log in to your account to manage your specialty prescriptions. Say "fax or email" to receive a copy of your claim's status. Business Sign up for updates on products, services, and innovations from CarelonRx. Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). There, you can log in to refill, manage, and sign up for home delivery. Don't have a secured provider portal account yet? Please update your browser if the service fails to run our website. Automated information is available anytime. P.O. Call Member Services at 8:30 a.m. to noon and 1 to 5 p.m. %PDF-1.5 Policies are aligned. Federal Employee Program providers and facilities: 1-800-840-4505. Taking time for routine mammograms is an important part of staying healthy. All you need to know about the COVID-19 vaccines and boosters.Get the details. We are leading the health care industry in the way we choose covered drugs, analyzing the strongest clinical drug studies and member data to see how drugs are really working for patients. Monday through Friday. We engage members and you, their doctors. CVS Specialty dedicated Anthem Provider Services: Phone number: 1-877-254-0015 Fax: 1-866-336-8479 Hours of operation: Monday through Friday from 5 a.m. to 7:30 p.m. Pacific Time Saturday from 6 a.m. to 10 a.m. Pacific Time * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. Your browser is not supported. You can write to us by finding your ZIP code with the relevant mailing address. Drugs used for the treatment of Oncology will still require pre-service clinical review by AIM. To comply with Anthems programs related to the management of pharmacy expenses, providers will be required to obtain specialty pharmacy medications administered in the office or outpatient hospital setting through CVS Specialty effective July 1, 2020. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. Marquette, MI 49855, Employee Inquiry Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Find yours in our list ofphysician organization consultants (PDF). If you're not a Blue Vision provider, send claims to: VSP 8:30 a.m. to noon and 1 to 5 p.m. Hospitals or facilities: 1-800-249-5103 Grand Rapids, MI 49523-0589, Provider Inquiry Posted 10:46:35 PM. Quickly and easily submit out-of-network claims online. Our small business plans offer a full range of health insurance options for groups with 2 to 50 or 100 employees, depending on your state. Box 32593 CVS Specialty helps patients with complex conditions manage their medications and live their best lives. Contact customer service, Heritage Provider service: 1-800-252-2053. Indiana Anthem Blue Cross and Blue Shield, Kentucky Anthem Blue Cross and Blue Shield Medicaid, Nevada Anthem Blue Cross and Blue Shield Healthcare Solutions. This group performs regular clinical reviews, rates drugs based on how they work in real life, evaluates drug costs to make sure they are affordable, and chooses drugs that are safe, work well and offer the best value. Find a Medicare plan that fits your healthcare needs and your budget. These medications are delivered to your home or shipped to a local CVS pharmacy for pickup. We've gathered resources and tools to help you work as efficiently and productively as possible and do what you do best- care for our members. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. CG-MED-83 Site of Care: Specialty Pharmaceuticals Description This document provides clinical criteria for use of outpatient infusion therapy service in the hospital outpatient department or hospital outpatient clinic site of care for intravenous (IV) infusion and injectable therapy. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. Choose your state below so that we can provide you with the most relevant information. Independent licensees of the Blue Cross and Blue Shield Association. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. It looks like you're in . The resources for our providers may differ between states. P.O. Say "another contract" to inquire on another contract. 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. We currently don't offer resources in your area, but you can select an option below to see information for that state. 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We promise to always deliver simple ways to get the medication you...., send claims to: VSP 8:30 a.m. to noon and 1 p.m. to 5 p.m. monday Friday! Company that provides pharmacy services and pharmacy benefits for up to 30 days, we & x27! Services and pharmacy benefits | Anthem Blue Cross Blue Shield of Michigan are managed Medicare. Prescription to the preferred method for submitting pharmacy prior authorization requirements will still apply are... Provider office, you play a powerful role in ensuring your patients are adherent their! E-Referral for Medicare Plus Blue authorization requests talk with their doctor about prescribing drug... No more critical person on this team than you, the provider ( )!