In Ohio: Community Insurance Company. Understand your care options ahead of time so you can save time and money. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. 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. Access your member ID card from our website or mobile app. Blue Cross Blue Shield of Michigan. Monday through Friday Monday through Friday, Care Management--Mail Code C355 Understand your care options ahead of time so you can save time and money. P.O. Choose your location to get started. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. Essential Vision providerssubmit claims throughHeritage Vision Plan. Verify patient eligibility and benefits Choose your state below so that we can provide you with the most relevant information. You get your health insurance plan from an employer or if you have certain grandfathered plans. Monday through Friday Get access to your online account. 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. It looks like you're outside the United States. Your dashboard may experience future loading problems if not resolved. If you have questions or need assistance, we're always here to help. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. 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. 1-888-826-8152 Federal Employee Program providers and facilities: 1-800-840-4505. 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. Start a Live Chat with one of our knowledgeable representatives. Get the mobile app
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. R-300913DescriptionThe Specialty Operations Pharmacy Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn. P.O. Box 2227 Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. 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. Search for specific text by using your Find function (Ctrl+F or Command+F). You can count on our guidance, education, and compassion throughout your entire course of treatment. Your dashboard may experience future loading problems if not resolved. Specialty medications are used to treat these conditions and often require special storage or extra support. Optum Connections includes videos, virtual visits, support texts and more all designed to help you understand your condition, manage your treatment, and live your best possible life. Our Patient Highlights communication is focused on controlled substance care opportunities, including the identification of members receiving multiple controlled substance medications, high-dose opioids or opioids from multiple providers and filled at multiple pharmacies, or combinations of controlled substances that may indicate risk. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Automated information is available anytime. You can also talk to your provider consultant. Register Now, Not registered? There's no more critical person on this team than you, the provider. Compare plans available in your area and apply today. 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. Step 5: Tell the system the date of service provided. The resources on this page are specific to your state. PO Box 385018 P.O. We see how drugs work in our members real lives and help them make good health care choices. Providing care for those who need it most requires a team effort. Birmingham, AL 35238-0518. 1-877-258-0167 8 a.m. to 6 p.m. 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. Important informationabout your 1095-B form. We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. 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. Monday through Friday. Box 32593 Just keep in mind you'll need to go through the prompts before you're connected to someone. Provider Inquiry Mail Code 0301 If you're not a Blue Vision provider, send claims to: VSP Step 6: Tell the system the total amount charged. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. The resources for our providers may differ between states. Call Pharmacy Member Services toll free at 1-833-370-7466 (TTY: 711) 24 hours a day, 7 days a week to ask us to mail you a Drug List. The resources for our providers may differ between states. 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. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. If specialty medications are obtained through other pharmacies, the claim will be denied. L07B We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). A specialty pharmacy does more than just fill prescriptions. Pharmacy Information for Providers. This applies to all Anthem Indiana commercial members. 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 look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. P.O. Blue Cross Blue Shield of Michigan 20500 Civic Center Drive All you need to know about the COVID-19 vaccines and boosters.Get the details. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Or Say "representative" to reach someone who can help. Our medical and pharmacy experts work collaboratively. Medicare Complaints, Grievances & Appeals. The Blue Cross name and symbol are registered marks of the Blue Cross Association. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. Vision providers who can't access their account or need more information can read the Blue Vision Provider Summary Guide (PDF) to learn how to: Submit claims, appeals and attachments 20500 Civic Center Drive endobj
In Connecticut: Anthem Health Plans, Inc. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. 1-800-482-4047 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. We look at how drugs work in the real lives of our members, then use our medical and pharmacy data and analyze claims analysis to make sure the medications really work. 1-855-504-2583 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. 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. 8:30 a.m. to noon and 1 to 5 p.m. Creating an account is free, easy and helps patients get their medications sooner. We promise to always deliver simple ways to get the medication you need. If you have Rx Maintenance 90 and use CVS, you can get a 90-day supply of any covered drug and pay your home delivery rate. 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. Search for specific text by using your Find function (Ctrl+F or Command+F). Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims We send members personalized messages about medications that may reduce their costs and include specific cost savings. You can count on our guidance, education, and compassion throughout your entire course of treatment. Grand Rapids, MI 49516-8710, BCN Advantage Claims Monday through Friday. 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. Monday through Friday Blue Cross Blue Shield of Michigan Say "claims" when the system asks why you're calling. Make your mental health a priority. Not connected with or endorsed by the U.S. Government or the federal Medicare program. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. 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 TTY users: To reach any number listed here, dial 711. One Woodward Avenue, Suite 2020 Automated information is available anytime. Call our Customer Service number, (TTY: 711). 1-844-876-7917 These pharmacies serve members with complex or chronic conditions. Vision and hearing providers: 1-800-482-4047 Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Everything we do centers ongetting you the prescriptionyou need, when you need it,your way. If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. 1-844-396-2329 (TTY 711). This applies to all specialty drugs covered through the Medicaid health maintenance organization (HMO) members medical benefits where Anthem has financial risk for the cost of specialty medications. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). 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. Find answers to all your questions with an Anthem representative in real time. Beginning, April 1, 2021, Anthem Blue Cross and Blue Shield (Anthem) is implementing a designated network for select specialty pharmacy medications administered in the office or the outpatient facility setting, Designated SRx Network. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Lets make healthy happen. You can write to us by matching your area code with the relevant mailing address. Anthem ( NYSE: ANTM ) is one of the largest managed care organizations in the United States. Jan 1, 2021 Our resources vary by state. Hospitals or facilities: 1-800-249-5103. Medical Prior Authorization requests can be submitted through CoverMyMeds. For dates of services on or after July 1, 2020, providers will be required to contact CVS Specialtys dedicated Anthem line listed below to order specialty medications for Medicaid HMO members. 8:30 a.m. to 4:30 p.m. CVS Specialty makes living with your condition easier. It looks like you're in . You purchased a plan on your state or federal Health Insurance Marketplace (also known as the exchange), You purchased coverage off the exchange and not through your employer, Your coverage is through a Small Group employer on, and in some cases, off the exchange. Box 312599 8 a.m. to noon and 1 to 5 p.m. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . Blue Care Network Pharmacy benefits Anthem Blue Cross and Blue Shield will administer pharmacy benefits for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. Get access to your agent portal.Register Now. Our automated interactive voice response system provides claims, benefit and cost-share information. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. Hospitals or facilities: 1-800-249-5103 Physicians and professionals: 1-800-344-8525 8:30 a.m. to noon and 1 to 5 p.m. <>
If you have questions, please contact your group administrator or your Anthem network representative. Grand Rapids, MI 49523-0589, Provider Inquiry Search for specific text by using your Find function (Ctrl+F or Command+F). Step 4: Say "no" when asked if you have additional questions about the determination of a claim. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. If you misplace your medicine or it is stolen, contact your provider. Say "fax or email" to receive a copy of your claim's status. 232 S Capitol Ave Contact will be made by an insurance agent or insurance company. 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 engage members and you, their doctors. Review medical and pharmacy benefits for up to three years. 1-800-822-2761 Attention: Claim Processing 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. 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. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. We currently don't offer resources in your area, but you can select an option below to see information for that state. Click on the link below to view a complete list of pharmacies participating in the Performance Network. Say "no" when asked if you have additional questions about the determination of a claim. Federal Employee Program providers and facilities: 1-800-482-3600 Providing care for those who need it most requires a team effort. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: We drive compliance to improve health and reduce costs. Your browser is not supported. We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. 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. You can order by phone whether or not you're already a member. Anthem Blue Cross and Blue Shield BadgerCare Plus and Medicaid SSI Programs Specialty pharmacy site of care Page 2 of 2 . P.O. Quickly and easily submit out-of-network claims online. 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. Specific Anthem Medications How to Write Step 1 - At the top of the form, supply the plan/medical group name, plan/medical group phone number, and plan/medical group fax number. If you don't have an account yet, you can check claims for with our automated system. Plus, you may qualify for financial help to lower your health coverage costs. These pharmacies serve members with complex or chronic conditions. P.O. If your state isn't listed, check out bcbs.com to find coverage in your area. If you're a provider who needs to contact us about one of our Blue Cross Blue Shield of Michigan, Blue Care Network or our Medicare products, start here. If your state isn't listed, check out bcbs.com to find coverage in your area. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. We also offer infusion services with Optum Infusion Pharmacy. Policies are aligned. 4 0 obj
Providers who don't have an account yet can mail a claim to one of the following: Blue Care Network Claims Get access to your agent portal. ??9h/dWn&}oS!LK$= -WY9#\3Lx]nO$~eRN s r^>}\;"YEL7%bl q!T{0K7YJXfvcFCB' -1CGC X"`*+\sdan'7"gA&e Xj-7U#%}593;BN`8Wkf8;lybv*kmUY~0FH+[Xkb%l]MQHKYR
Z/+r6M1]c@"] GnDIg=^iH u6+Ysu. 1-800-344-8525 The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. Specialty pharmacies are different. This applies to members with Preferred Provider Organization (PPO), HealthKeepers (HMO), POS AdvantageOne, and Act Wise (CDH plans). View listings below of the retail pharmacies that participate in our pharmacy networks. Learn more. Beginning, April 1, 2021, Anthem Blue Cross and Blue Shield (Anthem) is implementing a designated network for select specialty pharmacy medications administered in the office or the outpatient facility setting, Designated SRx Network. To access the current Designated Medical Specialty Pharmacy Drug List, visit anthem.com, select Providers, select the state Indiana (top right of page), select Forms and Guides (under the Provider Resources column). Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. It looks like you're in . Explore our comprehensive guides and video resources for more information regarding your condition. 8:30 a.m. to noon and 1 to 5 p.m. Available as CarelonRx core pharmacy network, the Performance Network includes nearly 40,000 independent and well-known retail pharmacies and big box stores across the country. Southfield, MI 48075. Members should talk with their doctor about prescribing a drug that is on the drug list. On April 1, 2020, Anthem notified physicians that it will soon require that specialty pharmacy medications administered in the office or outpatient hospital setting be obtained exclusively through CVS Specialty pharmacy. Say "another contract" to inquire on another contract. We look at claims data to find opportunities for our members to save money by switching them to lower-cost, therapeutically equivalent drugs. You can also visit bcbs.com to find resources for other states. Note:It can take up to 30 days for a claim to be processed. <>
To stay covered, Medicaid members will need to take action. In Kentucky: Anthem Health Plans of Kentucky, Inc. 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.
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