Anthem will cover the administration of COVID-19 vaccines with no cost share for in- and out-of-network providers, during the national public health emergency, and providers are not permitted under the federal mandate to balance-bill members. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. When member cost sharing has been waived (where permissible) by Anthem as outlined in this FAQ for COVID-19 testing and visits associated screening and/or tested for COVID-19, telehealth (video + audio) services, and in-network telephonic-only services, how does that impact provider reimbursement? Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. We're here to make sure you have the resources and care you need to keep yourself safe and well. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. Call 911 if you see emergency warning signs like the below. Will Anthem allow Roster Billing for the COVID-19 vaccine? Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. Anthem is relaxing early prescription refill limits, where permitted, for members who have Anthem pharmacy benefits and wish to refill a 30-day supply of most maintenance medications early. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Members who have health questions can also call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse. Every day, use household cleaner to wipe the surfaces of frequently-used equipment or devices. These actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and are central to the commitment of Anthems affiliated health plans to remove barriers for our members and support communities through this unprecedented time. Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. We use cookies on this website to give you the best experience and measure website usage. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. If you have a Medicaid plan with us, you do not have to pay anything for the COVID-19 test or the doctor visit to get the test. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. In Kentucky: Anthem Health Plans of Kentucky, Inc. Anthems affiliated health plans are committed to help provide increased access to care, while eliminating costs and help alleviate the added stress on individuals, families and the nations healthcare system. Dont stop taking your medicines as prescribed, and get your refills on time. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. If you have any questions, please contact the Provider Service number on the back of the members ID card, or your Provider Solutions contact on our Escalation Contact List. In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan's network. Symptoms can be mild to severe. What codes would be appropriate for COVID-19 lab testing? An airway and lung infection, similar to a cold. COVID-19 is a new strain of coronavirus that causes a highly contagious infection. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. If your doctor offers telehealth visits, your plan will pay for those, too. Anthem will cover the COVID-19 vaccine. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Providers may submit the COVID-19 Vaccination Roster Billing Form to Availity at https://www.availity.com/ by signing in and submitting the form electronically to the Anthem health plan. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. However, since COVID-19 is a new disease, scientists around the globe are racing to learn more about it. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated . Wash your hands often with soap and water for at least 20 seconds. They also are for people who have no symptoms but know or suspect that they have recently been exposed to someone who has COVID-19. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. All Rights Reserved. We partnered with findhelp, a social care network that connects you with local help. Plus, we will keep you updated as things develop. What you need to know about the disease and our coverage commitment. Are there any prescription drugs that can be used to treat COVID-19? Serving California. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. You may also receive a bill for any charges not covered by your health plan. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. Cant reach your doctor? Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Save your receipts when you purchase over-the-counter COVID-19 diagnostic tests. Visit your member website for information on how your health plan covers COVID-19 testing. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. 2021copyright of Anthem Insurance Companies, Inc. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Our benefits already state that if members do not have appropriate access to network physicians that we will authorize coverage for out-of-network physicians as medically necessary. div.treatment-testing-cont div.motif-icon.motif-marker:before { Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. The best way to prevent infection is to avoid being exposed to the virus. Some Anthem health plans include LiveHealth Online. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. How does my plan cover the over-the-counter test? The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. 132 0 obj <>/Filter/FlateDecode/ID[<7A556C2107D3FE4287A53DF79E9C5AC9><793C7E08A7A7684290861DE5BB023FB8>]/Index[111 45]/Info 110 0 R/Length 106/Prev 205504/Root 112 0 R/Size 156/Type/XRef/W[1 3 1]>>stream To avoid paying any out-of-pocket costs, you must go to an in-network retail pharmacy, take the testing kit to the pharmacy counter and provide your Service Benefit Plan member ID card to the pharmacist and/or pharmacy technician. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). We are not seeing any impacts to claims payment processing at this time. independent licensees of the Blue Cross and Blue Shield Association. Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. Cover your cough or sneeze with a tissue, and throw away the tissue. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues. Focusing solely on testing symptomatic patients may not be sufficient to prevent further transmission of COVID-19. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. Anthem is committed to working with and supporting our contracted providers. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. Additionally, members who have a pharmacy plan that includes a 90-day mail-order benefit should talk to their doctor about whether changing from a 30-day supply to a 90-day supply of their prescriptions is appropriate. Can I visit the emergency room for a test? Were sharing information about how you can protect yourself and the people you care about. Many thousands of people across the United States took part in research trials over many months. The visit and test are covered whether you get care in a doctors office, urgent care center or emergency department. 2023 Blue Cross Blue Shield Association. In general, it is recommended people get tested if they have symptoms including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat. On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved the Pfizer COVID-19 vaccine for individuals aged 16 years and older for emergency use authorization (EUA). Use of the Anthem websites constitutes your agreement with our Terms of Use. 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. Taking care of your emotional health is important during this stressful time. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. If you are not, please use our Test Site Finder to learn about options near you. Anthem recognizes the intense demands facing doctors, hospitals and all health care providers in the face of the COVID-19 pandemic. Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. Oct 13, 2022 Ordering at-home test kits from Anthem. Every home in the U.S. can order four at-home COVID-19 tests at no cost. Heres what the CDC says about COVID-19 vaccine safety. If your doctor isnt available for some reason, well help you find alternate care. Anthem will waive cost-sharing requirements for testing and the cost of the testing, and for emergency services related to COVID-19 screening or testing from any provider. Yes, but coverage for testing varies by plan. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Click below for the latest information for providers: The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the Novel Coronavirus (COVID-19) pandemic. As the number of COVID-19 cases in New Jersey moves in the wrong direction, Horizon Blue Cross Blue Shield of New Jersey will continue to do whats right for our members and communities. On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers. To learn where you can obtain a test visit the State of New Jerseys. Should providers who are establishing temporary locations to provide healthcare services during the COVID-19 emergency notify Anthem of the new temporary address(es)? Leading the way in health insurance since 1929. Payment for COVID-19 testing services on or after January 1, 2022. The health of our members is always our top priority. For more information, view our privacy policy. If their symptoms get worse, call their doctor. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. In Maine: Anthem Health Plans of Maine, Inc. Anthems enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthems Virtual Command Center for Emergency Management command, control and communication. This applies to all members, regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for COVID-19 vaccination. Talk to your doctor to see if a 90-day supply would work for you. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Cover your coughs and sneezes with tissues; discard the tissues. View insurance accepted, education, awards, and specialties for NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual. And if you use a pharmacy in Prime's network and check out at the pharmacy counter, you shouldn't have to pay upfront or submit a claim for reimbursement. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. Here are some tips: Older adults, people with disabilities, and people with diabetes orwho have severe chronic medical conditions like heart, lung or kidney disease seem to be at higher risk for more serious COVID-19 illness. Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. Heres everything you need to know about it. Clean and disinfect items and surfaces you touch . Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. To access your member services, please visit your BCBS company. What financial assistance is available for care providers during the COVID-19 crisis? Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Clean surfaces often, like countertops, doorknobs, light switches, faucets and more. Waiving cost-sharing for COVID-19 testing and treatment. Check out the changes and updates to our plan in 2023. 3. Who can order a test? Anthem is a registered trademark. %%EOF Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. div.treatment-testing-cont div.motif-icon.motif-syringe:before, Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. The electronic process is the quickest way to get the claims to Anthem. Reimbursement is available only during the COVID-19 public health emergency. www.cdc.gov/coronavirus. Are there any in-network or out-of-network limitations on these guidelines? The over-the-counter tests give results within 30 minutes. During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them: Effective March 20, 2020, hydroxychloroquine and chloroquine prescriptions will require a diagnosis code on the prescription. Anthem members will receive the COVID-19 vaccination at no cost, Anthem will help you coordinate COVID-19 care, Anthems alternative virtual care offerings, Prescription Medications and Pharmacy Services, Take advantage of emotional and mental health support. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. Similar to a cold or the flu. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? You should try to see your PCP or a doctor in your plan. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. These products are restricted from coverage through the pharmacy point-of-sale (POS) system. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. Our coverage commitment is to ensure our members can quickly access the right care at the right time. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. What CPT/HCPCS codes would be appropriate to consider for the administration of a COVID-19 vaccines? http://dhcfp.nv.gov/covid19 and the Nevada Health Response website at Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. Use the. What is changing regarding prior authorization requirements? Anthems affiliated health plans are also providing coverage for members to have an extra 30-day supply of medication on hand, and we are encouraging that when member plans allow that they switch from 30-day home delivery to 90-day home delivery. Anthem Blue Cross and Blue Shield Healthcare Solutions Member. Providers who currently submit electronic claims are encouraged to do so. FEP will waive copays for all virtual doctor visits by Teladoc during this time. The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. -webkit-border-radius: 50%; Schedule a COVID-19 test with your doctor. It lets you see a doctor through live chat or video on your phone, tablet, or computer. We will support you and help you get the care you need. In addition, Anthem has established a team of experts to monitor, assess and help facilitate timely mitigation and response where we have influence as appropriate for the evolving novel coronavirus threat. Administrative. This extension applies to Horizon BCBSNJs fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies. Each state will decide how and when to distribute vaccines. The protection of your privacy will be governed by the privacy policy of that site. .treatment-testing-cont:nth-child(2) { Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. You'll need to submit them when you apply for reimbursement. Members will pay no deductible, copay or coinsurance for services ranging from doctors visits to hospital stays when their testing or treatment is related to COVID-19. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. No copays for telehealth services provided by Teladoc. Visit COVIDtests.gov to order your free test kits. Cost shares will be waived for in-network providers only. Pain or pressure in the chest that wont go away. If it doesnt, we can talk about your options. If you have specific questions about the medicine you take, call the pharmacy services number on your member ID card.*. The guidance here can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)-contracted laboratories and identify the proper CPT codes to use. border-radius: 50%; CDC information for household members and caregivers can be found here. https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. Eligible members can find an in-network doctorhereor access HorizonCareOnline through the Horizon Blue app,www.horizoncareonline.com, orwww.HorizonBlue.com. The Nevada Department of Health and Human Services (DHHS) and its Divisions, including the Division of Health Care Financing and Policy (DHCFP), are concerned about the effect of the pandemic on rates of anxiety, depression and suicide among youth. Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. What codes would be appropriate to consider for telehealth (audio and video) for physical, occupational, and speech therapies? What can I do to keep from running out of medication? BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. An active role in their health is a new disease, scientists around the globe are to! The care you need of use law are new resources to address economic..., Anthems affiliated health plans will cover telephonic-only visits with in-network providers keep yourself safe and well providers the! 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