FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. endstream endobj startxref The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. } Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Every home in the U.S. can order four at-home COVID-19 tests at no cost. 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 . 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. 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. The best way to prevent infection is to avoid being exposed to the virus. Anthems affiliated health plans are committed to help provide increased access to care, while eliminating costs and help alleviate the added stress on individuals, families and the nations healthcare system. 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. Providers who currently submit electronic claims are encouraged to do so. 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 you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. Heres what the CDC says about COVID-19 vaccine safety. We are not seeing any impacts to claims payment processing at this time. The most common early symptoms appear between 2 and 14 days after being infected. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. 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. 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. No. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. 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. Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. independent licensees of the Blue Cross and Blue Shield Association. Were sharing information about how you can protect yourself and the people you care about. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. font-size: 50px; 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. You should try to see your PCP or a doctor in your plan. 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. 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. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. Providers should continue to verify eligibility and benefits for all members prior to rendering services. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. Visit the CDC website for the most up-to-date testing guidance. People who are diagnosed with COVID-19 may have long-term symptoms. Your member ID card is your key to using your medical plan benefits. 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. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. 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 cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. 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. In Indiana: Anthem Insurance Companies, Inc. 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. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. In Kentucky: Anthem Health Plans of Kentucky, Inc. 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. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. Whenever possible, the person with COVID-19 should be alone and using a separate room and/or bathroom. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. Cost shares will be waived for in-network providers only. }. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. Anthem is committed to making sure you can get the care you need. 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. Go to the main page on anthem.com/ca to log in and search for a doctor, or call the Member Services number on your ID card. 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. Blue Cross recommends that members contact and work closely with their health care . Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment Administrative. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. 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). administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. If you have questions about your COVID-19 benefits, please call the Member Services number on your ID card. Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Are COVID-19 tests covered? We will support you and help you get the care you need. https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. 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. All Rights Reserved. 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. 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. Anthem is committed to helping our members gain timely access to care and services in a way that places the least burden on the health care system. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. Here is what the CDC recommends. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Call the Pharmacy Member Services number on your ID card to find out about your options. cost sharing for telephonic-only in-network visits from March 19, 2020, through January 11, 2023, for fully-insured employer-sponsored, individual and Medicaid plans. 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. 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. 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. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. 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 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. Cover your coughs and sneezes with tissues; discard the tissues. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. Centers for Disease Control and Prevention: About 2019 Novel Coronavirus (2019-nCoV) (January 28, 2020): 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 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. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. Leading the way in health insurance since 1929. We'll also explore the additional care and support available for your protection and everyday needs. For non-COVID-19 tests (like flu, RSV, etc.) However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. Anthem is a registered trademark. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. This applies to all members, regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for COVID-19 vaccination. 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. Anthem will process the claim as if there is no member cost sharing, as it does, for example, with preventive health services. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Need coverage now due to job loss? Members can call the Pharmacy Member Services number on their health plan ID card to learn more. The electronic process is the quickest way to get the claims to Anthem. 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