Monday through Friday. You can find yours by selecting your region: Not sure which region you're in? There, you can log in to refill, manage, and sign up for home delivery. Step 4: Say "yes" when asked if you have additional questions about the determination of the claim. P.O. 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. You can write to us by matching your area code with the relevant mailing address. P.O. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Your dashboard may experience future loading problems if not resolved. Blue Cross Blue Shield of Michigan Contact will be made by an insurance agent or insurance company. A specialty pharmacy does more than just fill prescriptions. Marquette, MI 49855, Employee Inquiry 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. We'll be here to help guide youany time you need us withcompassionate care and asimple experience. Step 5: Tell the system the date of service provided. The Prior Authorization process allows for the request and approval of these medications. Choose your state below so that we can provide you with the most relevant information. For help with AcariaHealth, call 1-800-511-5144 (TTY 1-800-955-8770), Monday through Friday, 8:00 a.m. to 10:00 p.m., Eastern time. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. 8 a.m. to 7 p.m. View our map (PDF). Blue Cross Blue Shield of Michigan CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. 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. 2005 - 2023 copyright of Anthem Insurance Companies, Inc. Hospitals or facilities: 1-800-249-5103 Members have one vendor, one contact, and one ID card. You can count on our guidance, education, and compassion throughout your entire course of treatment. We currently don't offer resources in your area, but you can select an option below to see information for that state. P.O. Say "another contract" to inquire on another contract. Please update your browser if the service fails to run our website. Blue Cross Blue Shield of Michigan Call Member Services at In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. If you don't have an account yet, you can check claims for with our automated system. 8:30 a.m. to noon and 1 to 5 p.m. Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims To report fraud, waste or abuse, call our hotline: 1-800-437-3803 Explore our resources. IngenioRx Specialty Pharmacy provides your specialty medications. We provide health insurance in Michigan. Get access to your agent portal. 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 Our resources vary by state. 1-888-803-4960 Jan 1, 2021 New Directions. Please refer to the preferred drug list (PDL) when prescribing for these members. 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). Note: The FEP phone system has a different set of prompts than the others. % 1-877-258-0167 It looks like you're outside the United States. The Rx Choice Tiered Network may not be available in all states. You can also talk to your provider consultant. It can also send you a copy of your claim's status. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Members dont receive multiple letters focused on individual clinical and cost-of-care programs. 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. 8:30 a.m. to noon and 1 to 5 p.m. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: Federal Employee Program providers and facilities: 1-800-840-4505. Blue Care Network Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. Blue Cross Blue Shield of Michigan Business Sign up for updates on products, services, and innovations from CarelonRx. Specialty medications are used to treat these conditions and often require special storage or extra support. Just keep in mind you'll need to go through the prompts before you're connected to someone. Find yours in our list ofphysician organization consultants (PDF). We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. 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. Understand your care options ahead of time so you can save time and money. When you're contracted with us you have access to a provider consultant. 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. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Federal Employees Program 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. Look for these symbols in the pharmacy listings: Pharmacy search tips: 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. 8 a.m. to noon and 1 to 5 p.m. Hospitals or facilities: 1-800-249-5103 Providers who don't have an account yet can mail a claim to one of the following: Blue Care Network Claims Detroit, MI 48226. And to help ensure coordination of care and compliance, physicians also receive a consolidated communication with similar messages. Monday through Friday We send members personalized messages about medications that may reduce their costs and include specific cost savings. If you misplace your medicine or it is stolen, contact your provider. Large Group Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. L07B 415 S. McClellan Ave. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. You can order by phone whether or not you're already a member. 711. Anthem ( NYSE: ANTM ) is one of the largest managed care organizations in the United States. Drugs used for the treatment of Oncology will still require pre-service clinical review by AIM. 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. 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. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. View listings below of the retail pharmacies that participate in our pharmacy networks. Log in to your account to manage your specialty prescriptions. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. The resources for our providers may differ between states. Find answers to all your questions with an Anthem representative in real time. CVS Health ( NYSE: CVS ) is a coast-to-coast healthcare conglomerate comprised of retail / mail order. 1-800-482-5982 This applies to all Anthem Indiana commercial members. Our automated interactive voice response system provides claims, benefit and cost-share information. Say "another member" to inquire on another member. Step 7:Listen to your claim's status, which includes the following information: Step 8: After listening to the claim's status, you'll have the following choices: The automated system is available anytime. There's no more critical person on this team than you, the provider. Hospitals or facilities: 1-800-249-5103. London, KY 40742. PO Box 385018 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. 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. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. You can also visit. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). The automated system is available anytime. Provider Inquiry Mail Code 0301 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. 3 0 obj 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 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. We engage members and you, their doctors. In Indiana: Anthem Insurance Companies, Inc. Monday through Friday, Care Management--Mail Code C355 Say "representative" to reach someone who can help. x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ 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. Not registered? Find a Participating Pharmacy in Your Area. Southfield, MI 48075. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. If you're not a Blue Vision provider, send claims to: VSP endobj Not connected with or endorsed by the U.S. Government or the federal Medicare program. 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. Automated information is available anytime. Box 310166 Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Independent licensees of the Blue Cross and Blue Shield Association. Important informationabout your 1095-B form. Monday through Friday. AINPEC-2262-19 October 2019 Specialty Drug List 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. These pharmacies serve members with complex or chronic conditions. In Connecticut: Anthem Health Plans, Inc. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. We offer affordable health, dental, and vision coverage to fit your budget. 1-877-258-0167 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. As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. After a warning period to correct behavior, members become restricted to one pharmacy, designated as the home pharmacy. A partnership with our providers will enhance this programs ability to reduce the risk of opioid misuse and enable earlier identification of members facing substance use-related conditions. There are some things in life that we depend on. These pharmacies serve members with complex or chronic conditions. Lansing, MI 48933. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Just keep in mind you'll need to go through the prompts before you're connected to someone. 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 232 S Capitol Ave P.O. Compare plans available in your area and apply today. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. Contact customer service, Heritage Provider service: 1-800-252-2053. We use Availity Essentials as our provider portal. The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. We believe the right drugs to cover are the ones that do the best job for our members and reduce the total cost of care. A specialty pharmacy does more than just fill prescriptions. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Blue Cross Blue Shield of Michigan. 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. Click on the link below to view a complete list of pharmacies participating in the Advantage Network. Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. 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 6: Tell the system the total amount charged. 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 write to us by finding your area code with the relevant mailing address. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. If your state isn't listed, check out bcbs.com to find coverage in your area. London, KY 40742. Taking time for routine mammograms is an important part of staying healthy. Plus, you may qualify for financial help to lower your health coverage costs. Get access to your online account. Blue Cross Blue Shield of Michigan If you call before 30 days, we may not be able to check your claim through our automated phone system. Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. We also offer infusion services with Optum Infusion Pharmacy. 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'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. P.O. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. P.O. It looks like you're in . One Woodward Avenue, Suite 2020 Box 33248 Pay outstanding doctor bills and track online or in-person payments. Note:It can take up to 30 days for a claim to be processed. Say "date of service" to learn about a different claim. Explore our comprehensive guides and video resources for more information regarding your condition. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. P.O. 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. Search for specific text by using your Find function (Ctrl+F or Command+F). Get access to your agent portal.Register Now. 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. Step 1: Say "claims" when the system asks why you're calling. We encourage medications that improve patient health. 1-800-762-2382 Physicians and professionals: 1-800-344-8525 Register Now, Learn more about registering for our web tools. It looks like you're in . 1-844-876-7917 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. If you need additional guidance, read the Dentaquest Dental Manual (PDF). IngenioRx is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. You can use our automated system to reach a representative to discuss your claim's outcome. Box 68753 Register Now, Not registered? Search for specific text by using your Find function (Ctrl+F or Command+F). These pharmacies serve members with complex or chronic conditions. The automated system is available anytime. Box 312599 Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Price a medication, find a pharmacy,order auto refills, and more. 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. 1-844-396-2329 (TTY 711). ??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. Specialty pharmacies have highly trained pharmacists and nurses to provide personal care and guidance to help you manage your condition. It can also send you a copy of your claim's status. National Accounts, Posts about using health Insurance and managing your health, Collections of learning resources and links to services, For Sydney Health users connect with others and find care programs, An Important Message for Members receiving care from Advanced Infusion Solutions (AIS). Members should talk with their doctor about prescribing a drug that is on the drug list. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . There is no cost for this service. The resources on this page are specific to your state. 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. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. Mar 10, 2023 05:00pm. Birmingham, AL 35238-0518. Attention: Claim Processing 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 use drug lists, along with gaps-in-care messaging, to support overall member health. 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. 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. endobj <> For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. 1-855-504-2583 8 a.m. to noon and 1 to 5 p.m. CVS Specialty will bill us, and we will pay them directly. 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. We see how drugs work in our members real lives and help them make good health care choices. Your browser is not supported. 1 0 obj Check ereferrals.bcbsm.com for detailed prior authorization information. Detroit, MI 48231-2599, Blue Cross Complete claims Call our Customer Service number, (TTY: 711). 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. 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. Providing care for those who need it most requires a team effort. The automated system is available anytime. Variety of prescription drugs we 'll be here to help ensure coordination care... 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Time and money offer resources in your area code with the most relevant information with AcariaHealth call... Pharmacists and nurses to provide personal care and asimple experience team than you the! Prompts before you 're contracted with us you have additional questions about the of... Rocky Mountain Hospital and medical service, Heritage provider service: 1-800-252-2053 Essential vision providerssubmit claims through specialty... Our care team our automated interactive voice response system provides claims, benefit and establishes prior authorization review. Authorization process allows for the treatment of Oncology will still require pre-service clinical review of specialty... Used to treat these conditions and often require special storage or extra support looks like you 're calling Indiana members! Help guide youany time you need us withcompassionate care and improve members overall heath authorization requirements in accordance all. 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