Anthem is a registered trademark. If their symptoms get worse, call their doctor. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Plus, we will keep you updated as things develop. 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. Call us at 888-832-2583 to explore your options. 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. View insurance accepted, education, awards, and specialties for NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Do you have medicines you take regularly? Use the. To access your member services, please visit your BCBS company. In Indiana: Anthem Insurance Companies, Inc. Does Anthem expect any slowdown with claim adjudication because of COVID-19? How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Telemedicine not only helps members get the care they need, but helps reduce the spread of the coronavirus protecting the health of our members and the doctors and nurses who care for them. }. 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. Does Anthem require use of a contracted provider for the COVID-19 lab test in order for waiver of the members cost share to apply? Providers should continue to verify eligibility and benefits for all members prior to rendering services. Anthem will process the claim as if there is no member cost sharing, as it does, for example, with preventive health services. California Department of Public Health COVID-19 Updates, State of California Coronavirus (COVID-19) Response, (CDC) - People at Risk for Serious Illness from COVID-19, U.S. Department of State, Travel Advisories, World Health Organization (WHO), Coronavirus, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), vaccination prevents severe illness, hospitalizations, and death, cdc.gov/coronavirus/2019-ncov/about/index.html. Do a video or phone visit with a doctor or therapist from home. To ensure you have access to the right care at the right time, FEP is waiving cost shares and prior authorization to support members care for COVID-19. Out-of-network coverage will be provided where required by law. 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. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. 3. Who can order a test? If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. Please review the Medicare and Medicaid specific sites noted below for details about these plans. An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. In Kentucky: Anthem Health Plans of Kentucky, Inc. CMS has provided the Medicare guideline to use the CS modifier: Error! To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. For COVID-19 treatments via telehealth visits, Anthems affiliated health plans will cover telehealth and telephonic-only visits from in-network providers and will waive cost shares through January 31, 2021. 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. What financial assistance is available for care providers during the COVID-19 crisis? Check out the changes and updates to our plan in 2023. Additionally, our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part to further support our stakeholders. Will Anthem allow Roster Billing for the COVID-19 vaccine? People who are diagnosed with COVID-19 may have long-term symptoms. -webkit-border-radius: 50%; What diagnosis codes would be appropriate to consider for a patient with known or suspected COVID-19 for services where a members cost shares are waived? Cover your cough or sneeze with a tissue, and throw away the tissue. You do not need a doctors order for the over-the-counter diagnostictest. 155 0 obj <>stream CDC information for household members and caregivers can be found here. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. We'll also explore the additional care and support available for your protection and everyday needs. Page one is in English and page two is in Spanish for each flyer. Information from Anthem for Care Providers about COVID-19 (Updated October 13, 2022). Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Effective from March 19, 2020, through May 31, 2021, unless a longer period is required by law, Anthem will cover telephone-only medical and behavioral health services from in-network providers and out-of-network providers when required by state. Horizon Blue Cross Blue Shield of New Jersey, Your Guide to No-Cost Testing and Treatment as COVID-19 Surges, COVID-19 Information Hub section on testing, Site-Neutral Payments Would Save Nearly $500 Billion Over 10 Years, Blue Cross Blue Shield Association Statement on Medicare Advantage Risk Adjustment Validation Rule, Blue Cross Blue Shield Association Policy Solutions Could Lower Health Care Costs by $767 Billion, Blue Cross Blue Shield Companies Form Synergie Medication Collective, a New Venture to Radically Improve Affordability and Access to Costly Medications for Millions of Americans, Congress Passes Meaningful Changes to Expand Mental Health Support, Improve Maternal Health, and Lower Costs for Consumers, Blue Cross and Blue Shield of Louisiana Offers Services to Members Affected by Hurricane Ida, Blue Cross Of Idaho And The Blue Cross Of Idaho Foundation For Health Commit To Expanding Health Equity Across Idaho, Blue Cross Blue Shield of Wyoming Announces New Board Member, James G. Springfield Named President of Blue Cross and Blue Shield of Texas. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. No. This extension applies to Horizon BCBSNJs fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part. COVID-19 testing and visits associated with COVID-19 testing. who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes. Future updates regarding COVID-19 will appear in the monthly Provider News publication. 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. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. Every day, use household cleaner to wipe the surfaces of frequently-used equipment or devices. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. FEP knows many of you have serious concerns and questions regarding COVID-19 (coronavirus), especially as it continues to significantly impact our daily lives. 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. You'll need to submit them when you apply for reimbursement. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. An airway and lung infection, similar to a cold. 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. Confusion; bluish lips or face; or unconsciousness. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. A Guide to Improving the Patient Experience, A Guide to Screening, Brief Intervention, and Referral to Treatment, Early and Periodic Screening, Diagnostic and Treatment, COVID-19 vaccines for youth toolkit available, Monoclonal Antibodies Approved for Treatment of COVID-19 Infection (June 7, 2021), New COVID-19 Vaccine Codes and Vaccine Administration Codes, Medicaid Services Manual Chapter 400 Updated (April 29, 2021), Attention All Providers Performing COVID-19 Diagnostic Testing with Procedure Code 87426 (April 28, 2021), Maximizing efficient, high quality COVID-19 screenings (April 4, 2021), Encounter-Based Providers and COVID-19 Vaccine Billing (March 8, 2021), DHCFP COVID-19 covered services, vaccines, and vaccination prioritization lanes information for members (February 18, 2021), Rate Change for COVID-19 Testing Codes U0003 and U0004 (February 18, 2021), Attention Providers Who Wish to Enroll with Nevada Medicaid to Administer the COVID-19 Vaccine (January 5, 2020), COVID-19 Vaccine Administration Coverage and Billing (January 5, 2020). Get the latest news and information from the CDC at No, prior authorization is not required for diagnostic services related to COVID-19 testing. See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. 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. Findings. If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. We use cookies on this website to give you the best experience and measure website usage. 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. font-size: 50px; For telehealth services rendered by a facility provider, report the CPT/HCPCS code with the applicable revenue code as would normally be done for an in-person visit, and also append either modifier 95 or GT. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. Visit your member website for information on how your health plan covers COVID-19 testing. Our coverage commitment is to ensure our members can quickly access the right care at the right time. If youd like additional support, please call the Member Services number on your member ID and ask for an Anthem Case Management Nurse. What you need to know about the disease and our coverage commitment. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. Yes, Anthem will accept Roster Billing from providers and state agencies that are offering mass vaccinations for their local communities. cost sharing for COVID-19 diagnostic tests as deemed medically necessary by a healthcare clinician who has made an assessment of a patient, including serology or antibody tests, for members of our employer-sponsored, individual, Medicare and Medicaid plans. Find free and reduced-cost support for food, transportation, housing, health and more. } Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. 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. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. It also lets you notify the CDC of any side effects you may experience. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. 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. Members can get their test covered at an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Pain or pressure in the chest that wont go away. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. How can a provider submit Anthems Roster Billing claim form? Visit the CDC website for the most up-to-date testing guidance. 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . div.treatment-testing-cont div.motif-icon.motif-user-male-circle:before, The DHCFP is asking for Nevada Medicaid providers to assist with providing these flyers to Nevada Medicaid recipients. Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. At-home test kits from Anthem: Are FDA-authorized. We are not seeing any impacts to claims payment processing at this time. Nevada Department of Health and Human Services Directors Office Urges Youth Screening (November 23, 2020), COVID-19 information from Anthem Blue Cross and Blue Shield Healthcare Solutions (October 22, 2020), Attention All Providers: New Phase 3 Provider Relief Funding Available (October 13, 2020), Deadline for Provider Relief Fund Has Been Extended to August 3, 2020 (July 23, 2020), HHS announces additional distributions from the Provider Relief Fund to eligible Medicaid and CHIP providers (6/15/2020), COVID-19 update: Guidance for telehealth/telephonic care for behavioral health services (June 9, 2020), Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment, COVID-19 update: Anthem Blue Cross and Blue Shield Healthcare Solutions suspends select prior authorization rules and announces significant policy adjustments in response to unprecedented demands on health care providers, Listen now! 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. 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 . Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. These trials show the FDA whether a vaccine is safe and effective. We know how important it is to continue taking your prescriptions as directed by your doctor. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. It lets you see a doctor through live chat or video on your phone, tablet, or computer. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. Dont stop taking your medicines as prescribed, and get your refills on time. Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. Wash your hands or use hand sanitizer when entering their house or room. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. Reimbursement for COVID-19 testing performed in a participating hospital emergency room or inpatient setting is based on existing contractual rates inclusive of member cost share amounts waived by Anthem. Administration for Community Living: COVID-19 and what you need to know, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), You can still use in-person diagnostic COVID-19 testing sites. Based on standard AMA and HCPCS coding guidelines, for participating hospitals with a lab fee schedule, Anthem will recognize the codes 87635 and U0002, and will reimburse drive thru COVID-19 tests according to the lab fee schedule inclusive of member cost-share amounts waived by Anthem. Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? Members can call the number on the back of their identification card to confirm coverage. Heres what the CDC says about COVID-19 vaccine safety. These products are restricted from coverage through the pharmacy point-of-sale (POS) system. Call 911 if you see emergency warning signs like the below. Need coverage now due to job loss? Yes, but coverage for testing varies by plan. Blue Cross recommends that members contact and work closely with their health care . Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. 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. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Members can check their symptoms and connect with a doctor right from their phone. We're here to make sure you have the resources and care you need to keep yourself safe and well. www.cdc.gov/coronavirus. 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. Taking care of your emotional health is important during this stressful time. Our standard health plan contracts do not have exclusions or limitations on coverage for services for the treatment of illnesses that result from a pandemic. 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 Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Psych Huboffers resources to help with pandemic-related stress such as social isolation, coping with grief and loss, and other mental health issues. 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. Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. 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. 111 0 obj <> endobj Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. 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. Please review the Medicare and Medicaid specific sites noted below for details about these plans. Anthem members have access to telehealth 24/7 through LiveHealth Online. Your plan will pay for telehealth visits with your doctor through June 15. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. Save your receipts when you purchase over-the-counter COVID-19 diagnostic tests. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Should providers who are establishing temporary locations to provide healthcare services during the COVID-19 emergency notify Anthem of the new temporary address(es)? Good health habits can also help prevent and fight COVID-19. At-home diagnostic tests can be purchased over the counter online, at a local pharmacy, or from a big-box store. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. Wash your hands often with soap and water for at least 20 seconds. Please note this coverage does not apply to LiveHealth Online visits. Good health habits can also help prevent and fight COVID-19. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. As an Anthem member, you have access to a wide range of online resources to help you and your family members address emotional health and life challenges. We know these are challenging times, and want you to know that we remain deeply committed to supporting you to get care and protect your overall health and wellbeing. FEP will also encourage members to use the 90-day mail order benefit, if available through your health plan.If you are having difficulty paying for your treatment, contact the retail pharmacy phone number on the back of your ID card for assistance. Anthem Case Management Nurse coping with grief and loss, and these plans services addition... Here to make sure you have the strength of Blue Cross Blue Shield companies are the. 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