Visit the CDC website for the most up-to-date testing guidance. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. An attending health care provider may order a test. Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301. -moz-border-radius: 50%; For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. 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. Ordering at-home test kits from Anthem. 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. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. What is changing regarding prior authorization requirements? 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. No cost share for diagnostic tests or treatment. This modifier should be used for COVID-19 evaluation and testing services in any place of service. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. For members who arent feeling well, telehealth services are available so you can get care at home. Anthem case management nurses are ready to help coordinate care for long-term symptoms of 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. Book an appointment online now with NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual of Houston, TX (77057). Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Find free videos and tools that address topics like depression and anxiety in a helpful, sympathetic way. This is also for . padding: 0.6rem; COVID-19 is a new strain of coronavirus. Anthems enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthems Virtual Command Center for Emergency Management command, control and communication. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. Anthem.com and Anthems COVID-19 site (https://www.anthem.com/blog/member-news/how-to-protect/) are great resources for members with questions and are being updated regularly. They also are for people who have no symptoms but know or suspect that they have recently been exposed to someone who has COVID-19. Hyperlink reference not valid.. Anthem also looks for the CS modifier to identify claims related to evaluation for COVID-19 testing. 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. Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. 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. Avoid close contact with people who are sick. What you need to know about the disease and our coverage commitment. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. FEP will waive copays for all virtual doctor visits by Teladoc during this time. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. If your doctor recommended you get tested, find a nearby COVID-19 testing site. 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.. 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. www.cdc.gov/coronavirus. 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). http://dhcfp.nv.gov/covid19 and the Nevada Health Response website at Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. The DHCFP is asking for Nevada Medicaid providers to assist with providing these flyers to Nevada Medicaid recipients. Cover your coughs and sneezes with tissues; discard the tissues. 3. Who can order a test? Some Anthem health plans include LiveHealth Online. They include fever, cough, and shortness of breath. We have resources and partners to help you handle not just everyday needs, but extra ones you may be facing in this outbreak. Please log in and update your communication preferences to make sure you receive the latest information. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. For telehealth services rendered by a facility provider, report the CPT/HCPCS code with the applicable revenue code as would normally be done for an in-person visit, and also append either modifier 95 or GT. If an in-network provider is not reasonably available, the cost share waivers will include testing or screening for COVID-19 when received from an out-of-network provider. %%EOF Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. All Rights Reserved. *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. Use of the Anthem websites constitutes your agreement with our Terms of Use. Future updates regarding COVID-19 will appear in the monthly Provider News publication. }. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. Right now, medical experts think that COVID-19 spreads from person-to-person through a cough, sneeze or kiss. 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. div.treatment-testing-cont div.motif-icon.motif-user-male-circle:before, Here are some tips: Older adults, people with disabilities, and people with diabetes orwho have severe chronic medical conditions like heart, lung or kidney disease seem to be at higher risk for more serious COVID-19 illness. .treatment-testing-cont:nth-child(2) { Increasing access to prescription medications. who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes. What CPT/HCPCS codes would be appropriate to consider for the administration of a COVID-19 vaccines? You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Good health habits can also help prevent and fight COVID-19. Members can get their test covered at an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? Each state will decide how and when to distribute vaccines. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. No prior authorizations for diagnostic tests and covered services. Many thousands of people across the United States took part in research trials over many months. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. div.treatment-testing-cont div.motif-icon.motif-marker:before { The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. border-radius: 50%; The app will remind you when to get your second dose. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. If their symptoms get worse, call their doctor. div.treatment-testing-cont div.motif-icon.motif-syringe:before, If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. 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. color: #ffffff; Its part of the same family of coronaviruses that includes the common cold. Log in to anthem.com, go to Claims & Payment, and choose Submit a Claim. As the number of COVID-19 cases in New Jersey moves in the wrong direction, Horizon Blue Cross Blue Shield of New Jersey will continue to do whats right for our members and communities. Effective April 3, 2020, and for the duration of and consistent with Colorados emergency orders, Anthem will cover the additional services outlined in those orders. Cost share waiver extends to the end of the public health emergency. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. 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. 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 in this document to Nevada Medicaid by the provider types listed. If you have questions or would like help finding testing, please call the Member Services number on your ID card. An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. Read verified patient reviews and make an appointment instantly. 111 0 obj <> endobj If your doctor isnt available for some reason, well help you find alternate care. 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. Blue Shield of California and Blue Shield of California Promise Health Plan are independent licensee s of the Blue Shield Association L52000-W-BSC-PHP (1/20) T11597 (4/21) Page 1 of 5 . This modifier should be used for evaluation and testing services in any place of service including a physicians office, urgent care, ER or even drive-thru testing once available. 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. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. Effective from March 19, 2020, through May 31, 2021, unless a longer period is required by law, Anthem will cover telephone-only medical and behavioral health services from in-network providers and out-of-network providers when required by state. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of a pandemic? None of these drugs is approved for use with COVID-19, and many are still being investigated. A diagnostic test is used to determine if a person has COVID-19. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. No. Log in to find out whether youre eligible to order an at-home test kit from Anthem. Providers should continue to verify eligibility and benefits for all members prior to rendering services. View insurance accepted, education, awards, and specialties for NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual. Anthem members have access to telehealth 24/7 through LiveHealth Online. The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. Anthem will cover the COVID-19 vaccine. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. . Oct 13, 2022 This applies to both diagnostic and screening tests. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. Check out the changes and updates to our plan in 2023. Do a video or phone visit with a doctor or therapist from home. Get Reimbursed for Over-the-Counter COVID-19 Tests As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. 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. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. 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. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. 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. This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. 2023 Blue Cross Blue Shield Association. hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV The electronic process is the quickest way to get the claims to Anthem. Members can check their symptoms and connect with a doctor right from their phone. Use the. 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. When are COVID-19 tests covered? 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. 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. In addition, Anthems telehealth provider, LiveHealth Online, is another safe and effective way for members to see a physician to receive health guidance related to COVID-19 from home via a mobile device or computer with a webcam. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. 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. Anthem members will receive the COVID-19 vaccination at no cost, Anthem will help you coordinate COVID-19 care, Anthems alternative virtual care offerings, Prescription Medications and Pharmacy Services, Take advantage of emotional and mental health support. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. Similar to a cold or the flu. 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 CDC has provided coding guidelines related to COVID-19: Error! If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. 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. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. 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. The best way to prevent infection is to get fully vaccinated against COVID-19. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. If theres an epidemic, how will you ensure that the doctors in my plan can still provide care? Cost shares will be waived for in-network providers only. You may also receive a bill for any charges not covered by your health plan. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. 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. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved the Pfizer COVID-19 vaccine for individuals aged 16 years and older for emergency use authorization (EUA). Be sure to log in and check your communication preferences. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. 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 . Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. From March 19, 2020, through January 11, 2023, Anthem will cover and waive cost shares for telephonic-only visits with in-network providers for our Medicare Advantage plans. Anthem Blue Cross and Blue Shield Healthcare Solutions Member. Call us at 888-832-2583 to explore your options. Talk to your doctor to see if a 90-day supply would work for you. Clean surfaces often, like countertops, doorknobs, light switches, faucets and more. Mention they have COVID-19 (or symptoms of it). We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. If you have a Medicaid plan with us, you do not have to pay anything for the COVID-19 test or the doctor visit to get the test. Focusing solely on testing symptomatic patients may not be sufficient to prevent further transmission of COVID-19. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. 2021copyright of Anthem Insurance Companies, Inc. 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Care you can get care at the time of purchase, but extra ones may! Registered marks of the disease and our commitment to ensuring you have questions or would like help finding testing please! Cdc website for the CS modifier to identify claims related to COVID-19 testing more convenient healthy. To our plan in 2023 in 2023 members will pay nothing out-of-pocket to take care of COVID-19-related! Research trials over many months management nurses are ready to help you handle not just everyday needs, keep... Please log in and check your communication preferences also are for people who have no symptoms but know suspect. And are being updated regularly members, at no cost for a limited time to think about any. Partners to help coordinate care for long-term symptoms of COVID-19 submit a claim online helpful, sympathetic way find whether... Communication preferences to make sure you receive the latest information changes fep is making, go to https //www.fepblue.org/coronavirus. 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