Anthem Blue Cross (Anthem) is pleased to offer CVS Specialty* as our designated specialty pharmacy for specialty medications administered in the office or outpatient hospital setting. March 2023 Anthem Provider News - Indiana, February 2023 Anthem Provider News - Indiana, New ID cards for Anthem Blue Cross and Blue Shield members - Indiana, Telephonic-only care allowance extended through April 11, 2023 - Indiana, January 2021 Anthem Provider News - Indiana. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. P.O. Say "another contract" to inquire on another contract. Box 68753 Find yours in our list ofphysician organization consultants (PDF). Your dashboard may experience future loading problems if not resolved. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. Medical and pharmacy strategies complement each other; theyre based on the same goals. Contact customer service, Heritage Provider service: 1-800-252-2053. Register Now, Not registered? If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. Log in to your account to manage your specialty prescriptions. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. Get access to your online account. Use of the Anthem websites constitutes your agreement with our Terms of Use. 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. Search for specific text by using your Find function (Ctrl+F or Command+F). Explore our resources. P.O. If you have questions, please contact your group administrator or your Anthem network representative. IngenioRx is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. You can use our automated system to reach a representative to discuss your claim's outcome. CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. % Use New Directions' WebPass tool. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. Individuals attempting unauthorized access will be prosecuted. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. Monday through Friday, Care Management--Mail Code C355 Log in at availity.com. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. The automated system is available anytime. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. Blue Cross Blue Shield of Michigan Please update your browser if the service fails to run our website. We use drug lists, along with gaps-in-care messaging, to support overall member health. 1-800-344-8525 Monday through Friday, Care Management--Mail Code C355 There, you can log in to refill, manage, and sign up for home delivery. Blue Cross Blue Shield of Michigan. Our automated interactive voice response system provides claims, benefit and cost-share information. Box 312599 Products & Programs / Pharmacy. 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. The resources for our providers may differ between states. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. 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. Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. L07B We offer home delivery, as well as Retail 90 and Smart 90 pharmacy networks as options for members to fill up to a 90-day supply of their medications. 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. Grand Rapids, MI 49516-8753, Blue Cross Complete Claims Policies are aligned. Automated information is available anytime. Plus, you may qualify for financial help to lower your health coverage costs. Blue Cross Blue Shield of Michigan If specialty medications are obtained through other pharmacies, the claim will be denied. Products & Programs / Pharmacy. The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. You can count on our guidance, education, and compassion throughout your entire course of treatment. There's no more critical person on this team than you, the provider. New member? 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. Federal Employees Program A specialty pharmacy does more than just fill prescriptions. Automated information is available anytime. We currently don't offer resources in your area, but you can select an option below to see information for that state. Your dashboard may experience future loading problems if not resolved. These pharmacies serve members with complex or chronic conditions. We look at claims data to find opportunities for our members to save money by switching them to lower-cost, therapeutically equivalent drugs. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. Get access to your online account.Register Now, Not registered? It can also send you a copy of your claim's status. Specialty drug list Anthem Blue Cross and Blue Shield Healthcare Solutions is contracted with Accredo as our exclusive pharmacy supplier for high-cost, specialty/injectable drugs that treat a number of chronic or rare conditions. Say "representative" to reach someone who can help. We currently don't offer resources in your area, but you can select an option below to see information for that state. Just keep in mind you'll need to go through the prompts before you're connected to someone. Hospitals or facilities: 1-800-249-5103 If you no longer qualify, we can connect you to the right options for you and your family. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Detroit, MI 48232-4248, Provider Inquiry Not registered? 8 a.m. to noon and 1 to 5 p.m. 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. Get access to your agent portal.Register Now. 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. Detroit, MI 48232-0593, UB-04 claims We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Our resources vary by state. IngenioRx* is the pharmacy benefits manager. This applies to members with Preferred Provider Organization (PPO), HealthKeepers (HMO), POS AdvantageOne, and Act Wise (CDH plans). 8:30 a.m. to noon and 1 to 5 p.m. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. The Rx Choice Tiered Network may not be available in all states. Step 4: Say "no" when asked if you have additional questions about the determination of a claim. 8 a.m. to 7 p.m. 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. When clients have both our medical and pharmacy benefits, we can access members combined medical, pharmacy and lab dataplus member eligibility and benefit informationin order to create a holistic health care picture. 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. London, KY 40742. Facility and Special Programs You can also visit. Both medical and pharmacy costs are our responsibility. 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. out of your benefits, find the best healthcare, and stay healthy. Grand Rapids, MI 49516-8710, BCN Advantage Claims 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. Step 2: Answer the prompts about your patient and whether you provided care in Michigan. Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. This applies to all Anthem Indiana commercial members. Get help with your copays by chatting with a patient care coordinator today. 8 a.m. to 5 p.m. See what specialty pharmacies are considered in-network. Compare plans available in your area and apply today. Choose your location to get started. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. 3 0 obj What you need to know about the coronavirus, COVID-19. As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. Lets make healthy happen. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. 1-877-258-0167 We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. Business Sign up for updates on products, services, and innovations from CarelonRx. 1-800-762-2382 Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. The automated system is available anytime. Say "date of service" to learn about a different claim. The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. Medicaid renewals are starting. 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. Scroll down and select Pharmacy in the Category drop down. Monday through Friday As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. Providing care for those who need it most requires a team effort. It looks like you're in . Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . Monday through Friday. Step 4: Say "yes" when asked if you have additional questions about the determination of the claim. If you need additional guidance, read the Dentaquest Dental Manual (PDF). 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. Note:It can take up to 30 days for a claim to be processed. All you need to know about the COVID-19 vaccines and boosters.Get the details. The automated system is available anytime. We use Availity Essentials as our provider portal. Blue Vision providers submit claims electronically directly toVSP. We currently don't offer resources in your area, but you can select an option below to see information for that state. One Woodward Avenue, Suite 2020 For help with AcariaHealth, call 1-800-511-5144 (TTY 1-800-955-8770), Monday through Friday, 8:00 a.m. to 10:00 p.m., Eastern time. Monday through Friday. Search for specific text by using your Find function (Ctrl+F or Command+F). If your state isn't listed, check out bcbs.com to find coverage in your area. These pharmacies serve members with complex or chronic conditions. Explore programs available in your state. We encourage medications that improve patient health. You can write to us by finding your area code with the relevant mailing address. When you email us, we'll call . Specialty medications are used to treat these conditions and often require special storage or extra support. For the Rx Choice and Base Networks, you can also find Retail 90 and Rx Maintenance 90 pharmacies where you can obtain up to a 90-day supply of your medicine, including CVS. We also offer infusion services with Optum Infusion Pharmacy. Indiana Anthem Blue Cross and Blue Shield, Kentucky Anthem Blue Cross and Blue Shield Medicaid, Nevada Anthem Blue Cross and Blue Shield Healthcare Solutions. Get access to your agent portal. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. Blue Cross Blue Shield of Michigan Our medical and pharmacy experts work collaboratively. stream State and Federal Privacy laws prohibit unauthorized access to Member's private information. 711. Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. Employers can choose from a variety of medical, pharmacy, dental anthem specialty pharmacy vision, life, disability! 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