The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Hyperlink reference not valid. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? A few things to know: Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is coveredunder certain conditions. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Effective May 1, 2021, for members of our fully-insured employer and individual plans, as well as self-funded plans, Anthem will reimburse for the administration of COVID-19 FDA-approved vaccines at a rate of $40 per administration. This information can be found in the, March 2023 Anthem Provider News - Colorado, February 2023 Anthem Provider News - Colorado, Working with Anthem webinars - January 2023 overview, Telephonic-only care allowance extended through April 11, 2023 - Colorado, January 2023 Anthem Provider News - Colorado, https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies, Allowed Virtual Services (Telehealth/Telemedicine), https://www.anthem.com/blog/member-news/how-to-protect/, https://www.anthem.com/docs/public/inline/COV19_BillRoster_ABCBS.pdf, Federal Resources Available for Care Providers and Employers in the Federal CARES Act, COVID-19 Information Colorado Publication RETIRED as of November 8, 2022. cost sharing for the treatment of COVID-19 from April 1, 2020, through January 31, 2021, for members of our fully-insured employer, Individual, Medicare Advantage and Medicaid plans. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention (CDC) to help us determine what action is necessary on our part. 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. No prior authorizations for diagnostic tests and covered services. Do you have medicines you take regularly? For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. 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. Increasing access to prescription medications. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. Use Psych Hub's resources to help you manage and cope in stressful times. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. What CPT/HCPCS codes would be appropriate to consider for the administration of a COVID-19 vaccines? Please log in and update your communication preferences to make sure you receive the latest information. Effective April 3, 2020, and for the duration of and consistent with Colorados emergency orders, Anthem will cover the additional services outlined in those orders. The cost-sharing waiver includes copays, coinsurance and deductibles. Good health habits can also help prevent and fight COVID-19. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. } What is changing regarding prior authorization requirements? BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. div.treatment-testing-cont div.motif-icon.motif-marker:before { We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. What codes would be appropriate for COVID-19 lab testing? Where permissible, these guidelines apply to FEP members. 3. Who can order a test? 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. How can I find a COVID-19 testing location? And let them know if youve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. Findings. Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. Reimbursement is available only during the COVID-19 public health emergency. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. How can a provider submit Anthems Roster Billing claim form? Serving California. To access your member services, please visit your BCBS company. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. In addition, Anthems telehealth provider, LiveHealth Online, is another safe and effective way for members to see a physician to receive health guidance related to COVID-19 from home via a mobile device or computer with a webcam. Please note that the above information applies to Anthems Commercial health plans. Centers for Disease Control and Prevention: About 2019 Novel Coronavirus (2019-nCoV) (January 28, 2020): 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. 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. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. Anthem is committed to making sure you can get the care you need. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. Read verified patient reviews and make an appointment instantly. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. Our coverage commitment is to ensure our members can quickly access the right care at the right time. See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. Anthem members have access to telehealth 24/7 through LiveHealth Online. You can even get them through home delivery pharmacy. 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. Anthem is committed to working with and supporting our contracted providers. Information from Anthem for Care Providers about COVID-19 (Updated October 13, 2022). CMS has provided coding guidelines related to COVID-19 vaccines:https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. 2023 Blue Cross Blue Shield Association. Yes, but coverage for testing varies by plan. border-radius: 50%; endstream endobj startxref COVID-19 vaccines for youth toolkit available. 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. No. 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. Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301. The over-the-counter tests give results within 30 minutes. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. COVID-19 screening related tests (e.g., influenza tests, blood tests, etc.) Good health habits can also help prevent and fight COVID-19. Many plans include telephone care benefits during this public health emergency. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. Lets look at the latest information on COVID-19 and how your health care plan can help. Cover your cough or sneeze with a tissue, and throw away the tissue. If youre caring for someone, be sure visitors take care to avoid causing any extra risk to you or them keep hand sanitizer by the door, or ask visitors to wash their hands. Save your receipts when you purchase over-the-counter COVID-19 diagnostic tests. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. No. 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. padding: 0.6rem; If you have questions or would like help finding testing, please call the Member Services number on your ID card. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. 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). Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. 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. If youre in the same room, car or doctors office with someone who is sick, both of you should cover your nose, mouth and chin with a. To access your member services, please visit your BCBS company. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. Pain or pressure in the chest that wont go away. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. Get the latest news and information from the CDC at The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. Future updates regarding COVID-19 will appear in the monthly Provider News publication. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. All Rights Reserved. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Members can see an in-network doctor or use Horizon BCBSNJs telemedicine platform (HorizonCareOnline) for any covered purpose including diagnosis or treatment of COVID-19 and even for routine care or mental health care. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. What Are Your Thoughts On The Vaccines Against Covid-19? Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. No cost share for diagnostic tests or treatment. 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. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. Making healthcare affordable. Hydroxychloroquine and chloroquine will be covered only for FDA-approved indications: Visit the Division of Health Care Financing and Policy website at All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) Symptoms may appear 2-14 days after being around someone who has COVID-19. Call the Pharmacy Member Services number on your ID card to find out about your options. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? Check your COVID-19 benefits by using the Sydney Health or Engage Wellbeing mobile app, logging into anthem.com/ca, or calling the Member Services number on your ID card. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Anthem is a registered trademark. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. 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. Blue Shield of California and Blue Shield of California Promise Health Plan are independent licensee s of the Blue Shield Association L52000-W-BSC-PHP (1/20) T11597 (4/21) Page 1 of 5 . The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. No. For the Health of America. 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. When ordered by your doctor, testing, diagnosis and treatment for COVID-19 are available to Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members withzero out-of-pocket costs. 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. Oct 13, 2022 These trials show the FDA whether a vaccine is safe and effective. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Cost shares will be waived for in-network providers only. 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? Independent licensees of the Blue Cross and Blue Shield Association. Mild to severe fever, cough and shortness of breath. 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. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. We know how important it is to continue taking your prescriptions as directed by your doctor. Kaiser found: 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue Shield of California, Care First, Cigna, CVS Group/Aetna, and Kaiser Permanente) are currently relying only on . color: #ffffff; Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. This modifier should be used for evaluation and testing services in any place of service including a physicians office, urgent care, ER or even drive-thru testing once available. Wash your hands often with soap and water for at least 20 seconds. Member Discounts Take advantage of member-only discounts on health-related products and services. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. What is the best way that providers can get information to Anthems members on Anthems alternative virtual care offerings? The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. *Applies only for members with Anthem pharmacy benefits. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. 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. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. 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 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. 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. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Clean and disinfect items and surfaces you touch . Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. Schedule a COVID-19 test with your doctor. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. COVID-19 testing and visits associated with COVID-19 testing. We have made changes to how behavioral health providers can use and be compensated for telehealth (audio + video) and telephonic-only care with their patients. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Type at least three letters and we will start finding suggestions for you. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. Cost shares will be waived for emergency services related to COVID-19 testing or screening from either an in-network or out-of-network provider in Colorado. Please check the CDC for the most up-to-date list of symptoms. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. Were sharing information about how you can protect yourself and the people you care about. whQf C4[IiKd"3\D.IK^C]&zD"V2. The Department would like to bring to your attention the importance of the role you play as a provider in mental health screening and early identification of mental and behavioral health difficulties. Commercially insured members: 1-888-624-3096, Members covered through Medicaid plans: 1-800-711-5952, SHBP/SEHBP members: 1-800-414-SHBP (7427), Horizon Chat for Care may be available to some members at no cost through the companys free Horizon Blue app and. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. If it doesnt, we can talk about your options. None of these drugs is approved for use with COVID-19, and many are still being investigated. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. The most common early symptoms appear between 2 and 14 days after being infected. Are there any in-network or out-of-network limitations on these guidelines? 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