You may also receive a bill for any charges not covered by your health plan. 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. Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines. 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. Do these guidelines apply to members enrolled in the Blue Cross and Blue Shield Service Benefit Plan commonly referred to as the Federal Employee Program (FEP) through the Federal Employees Health Benefits Program? Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. For full details onbenefits, services and network coveragewhich may vary by health planfind each BCBS companys statement below: The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. Anthems affiliated health plans are committed to help our members gain timely access to care and services in a way that places the least burden on the healthcare system. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Plus, we will keep you updated as things develop. 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. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. If you are not, please use our Test Site Finder to learn about options near you. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Are there any prescription drugs that can be used to treat COVID-19? Please note this coverage does not apply to LiveHealth Online visits. 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. Oct 13, 2022 We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. None of these drugs is approved for use with COVID-19, and many are still being investigated. 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. Participating hospitals without lab fee schedules will follow the same lab testing reimbursement as defined in their facility agreement with Anthem inclusive of member cost share amounts waived by Anthem. What financial assistance is available for care providers during the COVID-19 crisis? Blue Shield and Blue Shield Promise will cover most COVID-19 tests at no out-of-pocket cost to you for specified plans noted below. *Applies only for members with Anthem pharmacy benefits. Anthem will cover telephonic-only medical and behavioral health services from in-network providers and out-of-network providers when required by state law. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. Call the Pharmacy Member Services number on your ID card to find out about your options. Navigate COVID-19 challenges like social isolation and job loss with a free mental health resource hub, powered by Psych Hub and supported by Anthem. 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 who currently submit electronic claims are encouraged to do so. Visit the CDC website for the most up-to-date testing guidance. People who are diagnosed with COVID-19 may have long-term symptoms. In addition to Availity.com, providers and state agencies who wish to submit Roster Billing claims can submit paper forms: Is there a specific diagnosis code Anthem would look for on the COVID-19 Vaccination Roster Billing Form? The DHCFP is asking for Nevada Medicaid providers to assist with providing these flyers to Nevada Medicaid recipients. In Connecticut: Anthem Health Plans, Inc. Be sure to log in and check your communication preferences. Mention they have COVID-19 (or symptoms of it). 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 While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. ET. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. margin-bottom: 40px; https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. Good health habits can also help prevent and fight COVID-19. The 90-day waiver of cost-shares for telehealth visits unrelated to COVID-19 (such as general medical and behavioral health care) applies to in and out of network providers. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of a pandemic? Book an appointment online now with NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual of Houston, TX (77057). Wash your hands often with soap and water for at least 20 seconds. 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. Many thousands of people across the United States took part in research trials over many months. Findings. Member Discounts Take advantage of member-only discounts on health-related products and services. Update your email address and choose the email option under Helpful Information to stay informed on COVID-19. %PDF-1.7 % Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Cover your cough or sneeze with a tissue, and throw away the tissue. 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. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. Call us at 888-832-2583 to explore your options. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. 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. For more information, view our privacy policy. And if you use a pharmacy in Prime's network and check out at the pharmacy counter, you shouldn't have to pay upfront or submit a claim for reimbursement. The Division of Health Care Financing and Policy (DHCFP) has created three flyers to provide information to Nevada Medicaid recipients on COVID-19 covered services, COVID-19 vaccines, and COVID-19 vaccination prioritization lanes. Effective March 17, 2020, through September 30, 2020, unless a longer period is required by law, Anthems affiliated health plans will waive member cost share for telehealth (video + audio) in-network visits, including visits for behavioral health, for our fully-insured employer plans and individual plans. If youd like additional support, please call the Member Services number on your member ID and ask for an Anthem Case Management Nurse. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. 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. Serving California. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. 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 . Anthem does not cover telephonic-only services today (with limited state exceptions) but we are providing this coverage effective from March 19, 2020, through January 11, 2023, to reflect the concerns we have heard from providers about the need to support continuity of care for Plan members during extended periods of social distancing. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. What can I do to keep from running out of medication? No. No. An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. We are fielding questions about the outbreak from our customers, members, providers and associates. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Ordering at-home test kits from Anthem. What codes would be appropriate for COVID-19 lab testing? cost sharing for visits where the purpose of the visit is to be screened and/or tested for COVID-19, regardless of whether test is administered, beginning March 18, 2020, for members of our employer-sponsored, individual, Medicare and Medicaid plans. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? The number one priority for Blue Cross Blue Shield (BCBS) companiesespecially as the nation faces this unprecedented health crisisis getting their members across the country the care they need. Anthem recognizes the intense demands facing doctors, hospitals and all health care providers in the face of the COVID-19 pandemic. Check the. All Rights Reserved. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. 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. Additionally, members who have a pharmacy plan that includes a 90-day mail-order benefit should talk to their doctor about whether changing from a 30-day supply to a 90-day supply of their prescriptions is appropriate. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. 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. Blue Cross recommends that members contact and work closely with their health care . 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. Member Discounts Take advantage of member-only discounts on health-related products and services. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. You may also receive a bill for any charges not covered by your health plan. 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. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. What Are Your Thoughts On The Vaccines Against Covid-19? We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. Whenever possible, the person with COVID-19 should be alone and using a separate room and/or bathroom. This modifier should be used for COVID-19 evaluation and testing services in any place of service. Other self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and we will continue to work with them to administer their plan designs as directed. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. Anthem members will receive the COVID-19 vaccination at no cost Coverage for COVID-19 testing COVID-19 treatment Visit a doctor from home Refill your prescription medication early Emotional and mental health support resources are available Sources Cost shares will be waived for in-network providers only. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. A diagnostic test is used to determine if a person has COVID-19. Serving California. div.treatment-testing-cont div.motif-icon.motif-user-male-circle:before, 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. The Nevada Department of Health and Human Services (DHHS) and its Divisions, including the Division of Health Care Financing and Policy (DHCFP), are concerned about the effect of the pandemic on rates of anxiety, depression and suicide among youth. 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. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? Providers can print double-sided or email these flyers to Nevada Medicaid recipients. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Screening tests show whether or not someone has COVID-19. 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. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. What CPT/HCPCS codes would be appropriate to consider for the administration of a COVID-19 vaccines? 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. To help reduce the burden on the states health care facilities and ensure members get the care they need when they need it, the cost-sharing waiver also applies totelemedicine visits, includingtelephonic visits. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. If you cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Reimbursement for over-the-counter tests. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. COVID-19 testing and visits associated with COVID-19 testing. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. Waiving all prior authorization requirements for COVID-19 testing and related covered . These products are restricted from coverage through the pharmacy point-of-sale (POS) system. FEP will waive copays for all virtual doctor visits by Teladoc during this time. However, since COVID-19 is a new disease, scientists around the globe are racing to learn more about it. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. %%EOF Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. The CDC has provided coding guidelines related to COVID-19: Error! No. Please review the terms of use and privacy policies of the new site you will be visiting. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. 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! How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? 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. No prior authorizations for diagnostic tests and covered services. Get Reimbursed for Over-the-Counter COVID-19 Tests. Providers should continue to verify eligibility and benefits for all members prior to rendering services. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. Here is what the CDC recommends. 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. Cost sharing will be waived for members using Anthems authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. Hyperlink reference not valid. Check out the changes and updates to our plan in 2023. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. 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. Today, unless otherwise required under state and federal mandates as detailed below, Anthem health plans will suspend select prior authorization (PA) requirements, member cost sharing, claims review and handling protocols to allow health care providers to focus on caring for patients diagnosed with COVID-19: We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. cost sharing for telehealth in-network visits for COVID-19 treatment from March 17, 2020, through January 31, 2021, including visits for behavioral health, for our fully-insured employer, individual plans, and where permissible, Medicaid. hk%@Z^ pp>ZV]X~ fE#E2y$IFD*r\Rtk^u_e,~tIG*aJ*h'URWjRJ=W*L)CCCBTjJ4Oo~x|~y|?x~|.o._=w_~w_{?G=o1q}w?\ZNwuw?Kw|/vCyvIY7?}Ngw}&UG-&F-w_=_,_=aUq+uK[W--kVtkKU=V5|Zq:4o]{u\Z-UCC5PqiU#]Eyfk]WJnv?/u]s9n'#~rk]f2x7-,}_[-mjeh5j7 o~L}5wQVeu,OkA4oSS3.U We use cookies on this website to give you the best experience and measure website usage. Information from Anthem for Care Providers about COVID-19 (Updated October 13, 2022). } Prior authorization is not required for COVID-19 testing. Independent licensees of the Blue Cross and Blue Shield Association. For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. Are there any in-network or out-of-network limitations on these guidelines? Anthem is a registered trademark. Good health habits can also help prevent and fight COVID-19. If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Its part of the same family of coronaviruses that includes the common cold. hbbd```b``:"@&@$2X&9 `2H2?bo X 2X* 0 * }X The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. 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