Providers who don't have an account yet can mail a claim to one of the following: Blue Care Network Claims Members have one vendor, one contact, and one ID card. Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims Click on the link below to view a complete list of pharmacies participating in the Performance Network. The resources for our providers may differ between states. 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. Note:It can take up to 30 days for a claim to be processed. You can write to us by finding your ZIP code with the relevant mailing address. Find out if your medication is available through CVS Specialty. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. The automated system is available anytime. London, KY 40742. The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Effective for dates of service March 1, 2022, and beyond, requests for the medications listed above and the clinical information submitted will be reviewed for both medical necessity of the medication itself (as is done We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. Essential Vision providerssubmit claims throughHeritage Vision Plan. CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. Start a Live Chat with one of our knowledgeable representatives. If you have questions, please contact your group administrator or your Anthem network representative. 8 a.m. to noon and 1 to 5 p.m. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. Please update your browser if the service fails to run our website. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Submit prior authorization requestselectronicallythrough CoverMyMeds. We help you find the lowestprices for the most effectivemedication. Automated information is available anytime. Our resources vary by state. Blue Care Network P.O. You'll need to use e-referral for Medicare Plus Blue authorization requests. If specialty medications are obtained through other pharmacies, the claim will be denied. 1-800-822-2761 Explore our comprehensive guides and video resources for more information regarding your condition. Plus, you may qualify for financial help to lower your health coverage costs. Say "claims" when the system asks why you're calling. 1-800-482-4047 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. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Get access to your agent portal. The link below provides the current list of drugs that must be obtained from CVS Specialty Pharmacy or another provider in our designated specialty pharmacy network. 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. 4 0 obj The automated system is available anytime. 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. Price a medication, find a pharmacy,order auto refills, and more. Monday through Friday Facility and Special Programs If you don't have an account yet, you can check claims for BCBSM patients with our automated system. Monday through Friday, 1-800-431-1059 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. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). 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. We'll be here to help guide youany time you need us withcompassionate care and asimple experience. Taking time for routine mammograms is an important part of staying healthy. Say "representative" to reach someone who can help. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: If your state isn't listed, check out bcbs.com to find coverage in your area. Blue Cross Blue Shield of Michigan State and Federal Privacy laws prohibit unauthorized access to Member's private information. Blue Vision providers submit claims electronically directly toVSP. One Woodward Avenue, Suite 2020 Specialty pharmacies are different. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. Birmingham, AL 35238-0518. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Medication is often one of them. 8 a.m. to 4 p.m. If you don't have an account yet, you can check claims for with our automated system. We see how drugs work in our members real lives and help them make good health care choices. You can also visit. If youre an administrative office of a medical care group, you have access to a professional organization consultant. PO Box 385018 Not connected with or endorsed by the U.S. Government or the federal Medicare program. It looks like you're outside the United States. Posted 10:46:35 PM. Box 7355 Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. Refill and track your specialty drug prescriptions, pay online, and get live support. Monday through Friday. Please call Accredo at 1-844-433-4878 or visit 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. Automated information is available anytime. CVS Specialty will bill us, and we will pay them directly. As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. Step 6:Tell the system the total amount charged. Lansing, MI 48933. Just keep in mind you'll need to go through the prompts before you're connected to someone. We offer affordable health, dental, and vision coverage to fit your budget. We encourage medications that improve patient health. Our automated interactive voice response system provides claims, benefit and cost-share information. You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. Products & Programs / Pharmacy. 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. You can find yours by selecting your region below. 20500 Civic Center Drive The Blue Cross name and symbol are registered marks of the Blue Cross Association. Understand your care options ahead of time so you can save time and money. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Detroit, MI 48231-0166, Federal Employee Program claims CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. 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. P.O. We currently don't offer resources in your area, but you can select an option below to see information for that state. Log in at availity.com. 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. Your browser is not supported. Our resources vary by state. The National Network varies by state and may apply if you get your health insurance plan from an employer, if you purchase your coverage yourself, or if you have certain grandfathered plans. Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. Register Now, Not registered? You can also visit bcbs.com to find resources for other states. Box 2227 1-844-396-2329 (TTY 711). TTY users: To reach any number listed here, dial 711. Say "date of service" to learn about a different claim. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. 1-855-504-2583 Monday through Friday. Blue Cross Blue Shield of Michigan The purpose of this communication is the solicitation of insurance. 1-800-762-2382 8 a.m. to noon and 1 to 5 p.m. Providers should continue to submit for administration of the medication, but not bill for the medication itself. 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. Make your mental health a priority. Use our app, Sydney Health, to start a Live Chat. Automated information is available anytime. Help for members impacted by the winter storms emergency in California, March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, June 2020 Anthem Blue Cross Provider News - California, Monday through Friday from 5 a.m. to 7:30 p.m. Pacific Time, Saturday from 6 a.m. to 10 a.m. Pacific Time. 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