Essential Vision providerssubmit claims throughHeritage Vision Plan. Featured In: We send members personalized messages about medications that may reduce their costs and include specific cost savings. 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. Choose your location to get started. Providing care for those who need it most requires a team effort. Monday through Friday Step 5: Tell the system the date of service provided. Get access to your employer portal. 4 0 obj This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. P.O. Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ <> Dental providers who can't able to access their account can read theDental Summary Guide (PDF)to learn how to: To use the document, you'll need to know if your patient has a Medicare Advantage plan, Federal Employee Program plan or a commercial plan. Attention: Claim Processing Detroit, MI 48232-4248, Provider Inquiry 8 a.m. to noon and 1 to 5 p.m. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. endobj Detroit, MI 48231-2599, Blue Cross Complete claims 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. 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. Monday through Friday 8:30 a.m. to noon and 1 to 5 p.m. Log in at availity.com. Access your member ID card from our website or mobile app. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. 415 S. McClellan Ave. Compare plans available in your area and apply today. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Search for specific text by using your Find function (Ctrl+F or Command+F). 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. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Please call Accredo at 1-844-433-4878 or visit P.O. Blue Cross Blue Shield of Michigan Log in to your account to manage your specialty prescriptions. 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. If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. These pharmacies serve members with complex or chronic conditions. Call Member Services at Cost-of-care and clinical programs focus on total costs, and we encourage medications that help to reduce those total costs. Use e-referral for authorizations for Blue Care Network and BCN AdvantageSM members. 20500 Civic Center Drive IngenioRx* is the pharmacy benefits manager. 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. Providers should continue to submit for administration of the medication, but not bill for the medication itself. 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. AINPEC-2262-19 October 2019 Specialty Drug List Don't have a secured provider portal account yet? Box 312599 Individuals attempting unauthorized access will be prosecuted. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. P.O. Step 1: Say "claims" when the system asks why you're calling. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Monday through Friday endobj 8:30 a.m. to noon and 1 to 5 p.m. 711. 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. Blue Cross Blue Shield of Michigan We currently don't offer resources in your area, but you can select an option below to see information for that state. You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. CVS Specialty will bill us, and we will pay them directly. If your state isn't listed, check out bcbs.com to find coverage in your area. Make your mental health a priority. Monday through Friday The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. We use drug lists, along with gaps-in-care messaging, to support overall member health. Members taking specialty drugs may need to get their prescription filled at an in-network specialty pharmacy in order for their drug to be covered under their pharmacy or medical benefit. Say "fax or email" to receive a copy of your claim's status. Marquette, MI 49855, Employee Inquiry 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. Get the mobile app Get access to your online account.Register Now, Not registered? 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. 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. These pharmacies serve members with complex or chronic conditions. If you have questions or need assistance, we're always here to help. Here to Help You. 8 a.m. to 7 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 . Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. 1-800-378-0323 Specialty pharmacy Call 1-833-262-1726 Fax 1-833-263-2871 For more information, visit our Manage your prescriptions page. Physicians and professionals: 1-800-344-8525 Or HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Get access to your agent portal.Register Now. Box 230589 Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. Please update your browser if the service fails to run our website. You can write to us by finding your area code with the relevant mailing address. Explore our comprehensive guides and video resources for more information regarding your condition. 1-800-482-4047 The automated system is available anytime. If you misplace your medicine or it is stolen, contact your provider. 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. Get access to your online account. You can order by phone whether or not you're already a member. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. Facility and Special Programs 8 a.m. to noon and 1 to 5 p.m. There, you can log in to refill, manage, and sign up for home delivery. Not sure which region you're in? 8 a.m. to 7 p.m. Vision and hearing providers: 1-800-482-4047. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Verify patient eligibility and benefits Business Sign up for updates on products, services, and innovations from CarelonRx. Grand Rapids, MI 49523-0589, Provider Inquiry 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. Grand Rapids, MI 49516-8753, Blue Cross Complete Claims For costs and complete details of the coverage, please contact your agent or the health plan. 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. Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. Detroit, MI 48232-0593, UB-04 claims Federal Employee Program providers and facilities: 1-800-482-3600 Providers who are not Designated SRx Network providers will be required to acquire the select specialty pharmacy medications administered in the office or the hospital outpatient setting through CVS Specialty Pharmacy. Monday through Friday. 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 If you don't have an account yet, you can check claims for BCBSM patients with our automated system. For Michigan Providers: Summary of Utilization Management Programs (PDF), Provider Prior Authorization and Precertification Requirements for BCBSM and Medicare Plus Blue, For Michigan Providers: BCN Referral and Prior Authorization Requirements (PDF), For Non-Michigan providers: Referral and Authorization Requirements (PDF), Important Information About MedicarePlans, Your 10-digit national provider identifier, BCBSM PIN or facility code, The members contract number, date of birth, the spelling of their first name and their ZIP code, Member liability, including deductible, coinsurance and copays. 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. We help you find the lowestprices for the most effectivemedication. Get access to your agent portal. 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