For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. If you have specific questions about the medicine you take, call the pharmacy services number on your member ID card.*. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. Please note that the following information applies to Anthem Blue Cross and Blue Shields (Anthem) Commercial health plans. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. .treatment-testing-cont:nth-child(2) {
Out-of-network coverage will be provided where required by law. If their symptoms get worse, call their doctor. Cover your cough or sneeze with a tissue, and throw away the tissue. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. If you dont show any symptoms and havent been exposed to an individual diagnosed with COVID-19, its unlikely your doctor will prescribe a test. No prior authorizations for diagnostic tests and covered services. Heres everything you need to know about it. Yes, Anthem will accept Roster Billing from providers and state agencies that are offering mass vaccinations for their local communities. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. 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. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. To ensure you have access to the right care at the right time, FEP is waiving cost shares and prior authorization to support members care for COVID-19. . div.treatment-testing-cont div.motif-icon.motif-marker:before {
How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. 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. 2021copyright of Anthem Insurance Companies, Inc. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. Members who have health questions can also call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse. Leading the way in health insurance since 1929. Visit your member website for information on how your health plan covers COVID-19 testing. If theres an epidemic, how will you ensure that the doctors in my plan can still provide care? 3. Who can order a test? 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? An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. COVID-19 is a new strain of coronavirus. Use the. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated . Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. Are COVID-19 tests covered? Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. 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. Anthem is committed to making sure you can get the care you need. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Visit COVIDtests.gov to order your free test kits. If you have Medicare, you wont pay for your vaccine, Stay Informed About COVID-19 and Prevention, The best way to prevent infection is to avoid exposure to the virus. Heres what the Centers for Disease Control and Prevention says about wearing a facemask. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Additionally, our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part to further support our stakeholders. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. In addition, Anthem will waive member cost shares for a limited set of remote monitoring codes (99453, 99454, 99457, or 99091) with in-network providers for visits coded with POS 02 and modifier 95 or GT. background-color: #7fcdbb;
Whenever possible, the person with COVID-19 should be alone and using a separate room and/or bathroom. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. 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. Check out the changes and updates to our plan in 2023. 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. COVID-19 vaccines are safe and effective. *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. Get the latest news and information from the CDC at 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 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 Taking care of your emotional health is important during this stressful time. At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. 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. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Providers should continue to verify eligibility and benefits for all members prior to rendering services. Here is what the CDC recommends. Need coverage now due to job loss? 2023 Blue Cross Blue Shield Association. You may also receive a bill for any charges not covered by your health plan. This includes visits for behavioral health for our fully insured employer plans, individual and Medicaid plans, where permissible. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. 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. 2023 Blue Cross Blue Shield Association. Read verified patient reviews and make an appointment instantly. No. 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). COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. Lets look at the latest information on COVID-19 and how your health care plan can help. Serving California. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. Please note that the above information applies to Anthems Commercial health plans. Cant reach your doctor? 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. Cost shares will be waived for in-network providers only. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. 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. In Kentucky: Anthem Health Plans of Kentucky, Inc. Clean surfaces often, like countertops, doorknobs, light switches, faucets and more. If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. Our standard health plan contracts do not have exclusions or limitations on coverage for services for the treatment of illnesses that result from a pandemic. No. Wash your hands or use hand sanitizer when entering their house or room. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? Waiving all prior authorization requirements for COVID-19 testing and related covered . If you are, youll be able to place an order. You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. 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. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Many thousands of people across the United States took part in research trials over many months. Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. What codes would be appropriate to consider for a telehealth visit with a patient who wants to receive health guidance during the COVID-19 crisis? Members can check their symptoms and connect with a doctor right from their phone. Johns Hopkins University has resources to help you learn more about the disease. Your member ID card is your key to using your medical plan benefits. Screening tests show whether or not someone has COVID-19. Dont stop taking your medicines as prescribed, and get your refills on time. If youre experiencing symptoms or if your doctor recommends a test, use our COVID-19 Test Site Finder to search your ZIP Code and find testing options near you. 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. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. Cover your coughs and sneezes with tissues; discard the tissues. Otenti said if someone has been near a person with COVID-19 within a two-week time frame, there is also good reason to test for the virus . 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. The over-the-counter tests give results within 30 minutes. If you have any questions, please contact the Provider Service number on the back of the members ID card, or your Provider Solutions contact on our Escalation Contact List. Anthem is a registered trademark. Anthem members also can call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse about health questions. Thats why we are committed to ensuring our members who are dealing with a diagnosis of COVID-19 can easily access the care they need.. 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. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. 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. Right now, medical experts think that COVID-19 spreads from person-to-person through a cough, sneeze or kiss. In Maine: Anthem Health Plans of Maine, Inc. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. whQf C4[IiKd"3\D.IK^C]&zD"V2. People at most risk of contracting COVID-19 or developing complications of illness are scheduled to receive vaccinations first. Treatment that's safe and convenient Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. All Rights Reserved. FEP will waive copays for all virtual doctor visits by Teladoc during this time. 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. *Applies only for members with Anthem pharmacy benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Find free and reduced-cost support for food, transportation, housing, health and more. Use of the Anthem websites constitutes your agreement with our Terms of Use. For the Health of America. We're here to make sure you have the resources and care you need to keep yourself safe and well. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. 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. If it doesnt, we can talk about your options. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. See the Allowed Virtual Services document located on anthem.com/For Providers/Provider Resources/Forms & Guides/Select a State/Allowed Virtual Services (Telehealth/Telemedicine) for allowable codes for telehealth visitsfor physical, occupational and speech therapies for visits coded with place of service (POS) 02 and modifier 95 or GT for our fully-insured employer, individual, Individual, Medicare Advantage plans and Medicaid plans, where permissible. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. You may also receive a bill for any charges not covered by your health plan. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Good health habits can also help prevent and fight COVID-19. Cost sharing will be waived for members using Anthems telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. For members who arent feeling well, telehealth services are available so you can get care at home. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Anthem is monitoring COVID-19 developments and what they mean for our associates and those we serve. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. 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. Wash your hands often with soap and water for at least 20 seconds. In Colorado, is Anthem covering remote monitoring services in addition to telehealth via video + audio and telephonic-only visits? BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. We are fielding questions about the outbreak from our customers, members, providers and associates. We have resources and partners to help you handle not just everyday needs, but extra ones you may be facing in this outbreak. padding: 0.6rem;
Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. Anthem will cover telephonic-only medical and behavioral health services from in-network providers and out-of-network providers when required by state law. ET. When are COVID-19 tests covered? Our benefits already state that if members do not have appropriate access to network physicians that we will authorize coverage for out-of-network physicians as medically necessary. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Talk to your doctor to see if a 90-day supply would work for you. Confusion; bluish lips or face; or unconsciousness. What Are Your Thoughts On The Vaccines Against Covid-19? Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. Providers may submit the COVID-19 Vaccination Roster Billing Form to Availity at https://www.availity.com/ by signing in and submitting the form electronically to the Anthem health plan. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. For COVID-19 treatments via telehealth visits, Anthems affiliated health plans will cover telehealth and telephonic-only visits from in-network providers and will waive cost shares through January 31, 2021. To help address care providers questions, Anthem has developed the following updates and frequently asked questions. 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. 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