The Blue Cross name and symbol are registered marks of the Blue Cross Association. Not registered? If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. 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. The purpose of this communication is the solicitation of insurance. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. 711. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. You'll need to use e-referral for Medicare Plus Blue authorization requests. ??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. Large Group Mar 10, 2023 05:00pm. Individuals attempting unauthorized access will be prosecuted. 1-844-396-2329 (TTY 711). The automated system is available anytime. P.O. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. Anthem is a registered trademark of Anthem Insurance Companies, Inc. It can also send you a copy of your claim's status. Box 312599 Monday through Friday Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. The Rx Choice Tiered Network may not be available in all states. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. Our small business plans offer a full range of health insurance options for groups with 2 to 50 or 100 employees, depending on your state. If youre an administrative office of a medical care group, you have access to a professional organization consultant. These pharmacies serve members with complex or chronic conditions. 1 0 obj 1-855-504-2583 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. These pharmacies serve members with complex or chronic conditions. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 a.m. to 8 p.m. ET/CT, 7 a.m. to 7 p.m. MT/PT. 8:30 a.m. to noon and 1 to 5 p.m. Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. It can also send you a copy of your claim's status. In Indiana: Anthem Insurance Companies, Inc. Quickly and easily submit out-of-network claims online. Box 230589 In Maine: Anthem Health Plans of Maine, Inc. Our resources vary by state. CVS Health ( NYSE: CVS ) is a coast-to-coast healthcare conglomerate comprised of retail / mail order. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. London, KY 40742. Medicare Complaints, Grievances & Appeals. We encourage medications that improve patient health. We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader. Monday through Friday. 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. From easy online refills to one-on-one CareTeam support from specially trained nurses and pharmacists, we give patients the care they need, when and where they need it. 1-888-826-8152 We also offer infusion services with Optum Infusion Pharmacy. Register Now, Not registered? You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. Detroit, MI 48231-0166, Federal Employee Program claims Register Now, Not registered? You can order by phone whether or not you're already a member. 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. We promise to always deliver simple ways to get the medication you need. Automated information is available anytime. Register Now, Not registered? You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: We drive compliance to improve health and reduce costs. Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. We currently don't offer resources in your area, but you can select an option below to see information for that state. Members dont receive multiple letters focused on individual clinical and cost-of-care programs. Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. Blue Cross Blue Shield of Michigan 20500 Civic Center Drive 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. Our clinical management program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more. Verify patient eligibility and benefits Providers who don't have an account yet can mail a claim to one of the following: Blue Care Network Claims We currently don't offer resources in your area, but you can select an option below to see information for that state. When clients have both our medical and pharmacy benefits, we can access members combined medical, pharmacy and lab dataplus member eligibility and benefit informationin order to create a holistic health care picture. 8:30 a.m. to 4:30 p.m. State and Federal Privacy laws prohibit unauthorized access to Member's private information. 1-800-482-5982 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. Log in to your account to manage your specialty prescriptions. Medication is often one of them. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. It looks like you're in . 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. Members have one vendor, one contact, and one ID card. Pharmacy Information for Providers. All specialty pharmacy prior authorization requirements will still apply and are the responsibility of the ordering provider. 20500 Civic Center Drive Blue Vision providers submit claims electronically directly toVSP. 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. Just keep in mind you'll need to go through the prompts before you're connected to someone. Choose your location to get started. P.O. stream Say "representative" to reach someone who can help. If you have Rx Maintenance 90 and use CVS, you can get a 90-day supply of any covered drug and pay your home delivery rate. Start a Live Chat with one of our knowledgeable representatives. Use of the Anthem websites constitutes your agreement with our Terms of Use. 8 a.m. to 7 p.m. Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. Get translation and interpretation services free of charge. Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. P.O. Providers should continue to submit for administration of the medication, but not bill for the medication itself. x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. Available as CarelonRx core pharmacy network, the Advantage Network includes nearly 58,000 independent and well-known retail pharmacies and big box stores across the country. As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. 1-888-803-4960 Not connected with or endorsed by the U.S. Government or the federal Medicare program. Hospitals or facilities: 1-800-249-5103 Monday through Friday. Members taking specialty drugs may need to get their prescription filled at an in-network specialty pharmacy in order for their drug to be covered under their pharmacy or medical benefit. 3 0 obj Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. Note: The FEP phone system has a different set of prompts than the others. Call Member Services at Get access to your employer portal. Products & Programs / Pharmacy. Box 2227 Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. 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. Call our Customer Service number, (TTY: 711). Southfield, MI 48075. Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. CVS Specialty dedicated Anthem Provider Services: Phone number: 1-877-254-0015 Fax: 1-866-336-8479 Hours of operation: 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 * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. IngenioRx Specialty Pharmacy provides your specialty medications. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Pharmacy benefits Anthem Blue Cross and Blue Shield will administer pharmacy benefits for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. 8 a.m. to 5 p.m. We offer flexible group insurance plans for any size business. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. Federal Employee Program providers and facilities: 1-800-482-3600 Explore programs available in your state. Step 6:Tell the system the total amount charged. Box 7355 View our map (PDF). New member? If you have any questions about your pharmacy benefits, call Pharmacy Member Services at 1-833-207-3120 (TTY 711) 24 hours a day, seven days a week. 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. In Kentucky: Anthem Health Plans of Kentucky, Inc. If you need more information, you can transfer to a customer service representative during business hours. Scroll down and select Pharmacy in the Category drop down. The resources for our providers may differ between states. Our Patient Highlights communication is focused on controlled substance care opportunities, including the identification of members receiving multiple controlled substance medications, high-dose opioids or opioids from multiple providers and filled at multiple pharmacies, or combinations of controlled substances that may indicate risk. CVS Specialty helps patients with complex conditions manage their medications and live their best lives. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Monday through Friday, Care Management--Mail Code C355 Jun 1, 2020 ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. The Prior Authorization process allows for the request and approval of these medications. There, you can log in to refill, manage, and sign up for home delivery. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. 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. Grand Rapids, MI 49523-0589, Provider Inquiry We also offer infusion services with Optum Infusion Pharmacy. Well take it from there. Monday through Friday Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Lansing, MI 48933. <>>> View our map (PDF). You can also talk to your provider consultant. If you're not a Blue Vision provider, send claims to: VSP Step 6: Tell the system the total amount charged. This applies to members with Preferred Provider Organization (PPO), HealthKeepers (HMO), POS AdvantageOne, and Act Wise (CDH plans). Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. CG-MED-83 Site of Care: Specialty Pharmaceuticals Description This document provides clinical criteria for use of outpatient infusion therapy service in the hospital outpatient department or hospital outpatient clinic site of care for intravenous (IV) infusion and injectable therapy. 1-877-258-0167 This applies to all Anthem Indiana commercial members. Federal Employees Program Step 4: Say "no" when asked if you have additional questions about the determination of a claim. These medications are delivered to your home or shipped to a local CVS pharmacy for pickup. These pharmacies serve members with complex or chronic conditions. Vision and hearing providers: 1-800-482-4047. Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? We provide health insurance in Michigan. Please update your browser if the service fails to run our website. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. What you need to know about the coronavirus, COVID-19. Check ereferrals.bcbsm.com for detailed prior authorization information. Grand Rapids, MI 49516-8710, BCN Advantage Claims We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. Physicians and professionals: 1-800-344-8525 In Connecticut: Anthem Health Plans, Inc. Monday through Friday. Here to Help You. TTY users: To reach any number listed here, dial 711. 232 S Capitol Ave It looks like you're outside the United States. To report fraud, waste or abuse, call our hotline: 1-800-437-3803 Posted 10:46:35 PM. Preferred Drug List and Formulary Search Hospitals or facilities: 1-800-249-5103 The resources on this page are specific to your state. Blue Cross Blue Shield of Michigan Say "another member" to inquire on another member. 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. 2005 - 2023 copyright of Anthem Insurance Companies, Inc. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2023. out of your benefits, find the best healthcare, and stay healthy. 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. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. We use Availity Essentials as our provider portal. The resources for our providers may differ between states. L07B Independent licensees of the Blue Cross and Blue Shield Association. Detroit, MI 48231-2599, Blue Cross Complete claims P.O. Monday through Friday. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's required. Don't have a secured provider portal account yet? <> 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. We look at claims data to find opportunities for our members to save money by switching them to lower-cost, therapeutically equivalent drugs. Box 68753 Use New Directions' WebPass tool. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. The resources for our providers may differ between states. Detroit, MI 48232-4248, Provider Inquiry Step 5:Tell the system the date of service provided. Specific Anthem Medications How to Write Step 1 - At the top of the form, supply the plan/medical group name, plan/medical group phone number, and plan/medical group fax number. With the Rx Choice Network, you can choose from two levels of coverage, helping to provide both savings and access: 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. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Blue Care Network 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). When you email us, we'll call . Our automated interactive voice response system provides claims, benefit and cost-share information. When you're contracted with us you have access to a provider consultant. 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. 2 0 obj Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. Understand your care options ahead of time so you can save time and money. Our medical and pharmacy experts work collaboratively.
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