In Ohio: Community Insurance Company. 8 a.m. to 7 p.m. Get access to your online account.Register Now, Not registered? The Pharmacy Home Program identifies members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances. The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. Find a Participating Pharmacy in Your Area. We look at how drugs work in the real lives of our members, then use our medical and pharmacy data and analyze claims analysis to make sure the medications really work. Southfield, MI 48075. Search for specific text by using your Find function (Ctrl+F or Command+F). When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. If you misplace your medicine or it is stolen, contact your provider. 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. If you no longer qualify, we can connect you to the right options for you and your family. What you need to know about the coronavirus, COVID-19. If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. Monday through Friday. 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. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. Find out if your medication is available through CVS Specialty. If you don't have an account yet, you can check claims for with our automated system. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play. 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. Our clinical management program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more. P.O. Physicians and professionals: 1-800-344-8525 The Rx Choice Tiered Network may not be available in all states. 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. The purpose of this communication is the solicitation of insurance. Specialty drug list Anthem Blue Cross and Blue Shield Healthcare Solutions is contracted with Accredo as our exclusive pharmacy supplier for high-cost, specialty/injectable drugs that treat a number of chronic or rare conditions. TTY users: To reach any number listed here, dial 711. 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. Get access to your agent portal.Register Now. The automated system is available anytime. Provider Inquiry Mail Code 0301 Blue Care Network 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. You can write to us by finding your ZIP code with the relevant mailing address. Monday through Friday, Care Management--Mail Code C355 Just keep in mind you'll need to go through the prompts before you're connected to someone. Mar 10, 2023 05:00pm. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. For Michigan Providers: Summary of Utilization Management Programs (PDF), Provider Prior Authorization and Precertification Requirements for BCBSM and Medicare Plus Blue, For Michigan Providers: BCN Referral and Prior Authorization Requirements (PDF), For Non-Michigan providers: Referral and Authorization Requirements (PDF), Important Information About MedicarePlans, Your 10-digit national provider identifier, BCBSM PIN or facility code, The members contract number, date of birth, the spelling of their first name and their ZIP code, Member liability, including deductible, coinsurance and copays. Preferred Drug List and Formulary Search Vision and hearing providers: 1-800-482-4047 Log in to your account to manage your specialty prescriptions. Some drugs, and certain quantities of some drugs, require an approval before they are eligible for coverage. Individuals attempting unauthorized access will be prosecuted. The resources for our providers may differ between states. 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. Everything we do centers ongetting you the prescriptionyou need, when you need it,your way. If a medication is selected that is not on the drug list, the member will be responsible for the full cost of the drug. London, KY 40742. P.O. Products & Programs / Pharmacy. We provide health insurance in Michigan. Here to Help You. Hospitals or facilities: 1-800-249-5103. 1-800-762-2382 There is no cost for this service. 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. Your dashboard may experience future loading problems if not resolved. New Directions. For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. Members have one vendor, one contact, and one ID card. 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. You can count on our guidance, education, and compassion throughout your entire course of treatment. Step 1: Say "claims" when the system asks why you're calling. In Kentucky: Anthem Health Plans of Kentucky, Inc. 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. Just keep in mind you'll need to go through the prompts before you're connected to someone. Blue Vision providers submit claims electronically directly toVSP. 1-800-482-4047 We currently don't offer resources in your area, but you can select an option below to see information for that state. Jan 1, 2021 This applies to all Anthem Indiana commercial members. P.O. Box 2227 Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. 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. Explore our resources. You can also talk to your provider consultant. Monday through Friday, 1-800-431-1059 Make your mental health a priority. Plus, you may qualify for financial help to lower your health coverage costs. 1-800-344-8525 ??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. You can also visit. 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. Step 5: Tell the system the date of service provided. 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. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. 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. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use New Directions' WebPass tool. Use of the Anthem websites constitutes your agreement with our Terms of Use. The resources for our providers may differ between states. Jun 1, 2020 Monday through Friday, Care Management--Mail Code C355 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 1-877-258-0167 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. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. There's no more critical person on this team than you, the provider. Get translation and interpretation services free of charge. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). These pharmacies serve members with complex or chronic conditions. A specialty pharmacy does more than just fill prescriptions. 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. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Medicare Complaints, Grievances & Appeals. 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. Say "another contract" to inquire on another contract. 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., 2022. We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. endobj 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. 1-800-822-2761 Drugs used for the treatment of Oncology will still require pre-service clinical review by AIM. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Register Now, Not registered? 1-844-396-2329 (TTY 711). Detroit, MI 48231-2599, Blue Cross Complete claims Policies are aligned. Click on the link below to view a complete list of pharmacies participating in the Performance Network. 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. Southfield, MI 48075, 1-877-293-2788 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). Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. Products & Programs / Pharmacy. Providing care for those who need it most requires a team effort. 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 Scroll down and select Pharmacy in the Category drop down. 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. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. Box 312599 You can write to us by matching your area code with the relevant mailing address. Medical and pharmacy strategies complement each other; theyre based on the same goals. Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. Independent licensees of the Blue Cross and Blue Shield Association. IngenioRx* is the pharmacy benefits manager. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. L07B Submit prior authorization requestselectronicallythrough CoverMyMeds. Contact customer service, Heritage Provider service: 1-800-252-2053. 1-888-803-4960 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. Well take it from there. Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. 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). Find a Medicare plan that fits your healthcare needs and your budget. Monday through Friday 8:30 a.m. to noon and 1 to 5 p.m. It looks like you're in . Physicians and professionals: 1-800-344-8525 Providing care for those who need it most requires a team effort. Box 68710 In Connecticut: Anthem Health Plans, Inc. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. 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. When you email us, we'll call . As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. 42I]?evMJz8q9|eszwdZL9}owq1}s&,/K{IP,xW^.` We help you find the lowestprices for the most effectivemedication. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. You can also visit bcbs.com to find resources for other states. Verify patient eligibility and benefits AINPEC-2262-19 October 2019 Specialty Drug List Indiana Anthem Blue Cross and Blue Shield, Kentucky Anthem Blue Cross and Blue Shield Medicaid, Nevada Anthem Blue Cross and Blue Shield Healthcare Solutions. Not registered? Start a Live Chat with one of our knowledgeable representatives. R-300913DescriptionThe Specialty Operations Pharmacy Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn. 8 a.m. to 5 p.m. If you're not a Blue Vision provider, send claims to: VSP Monday through Friday. Contact will be made by an insurance agent or insurance company. Physicians and professionals: 1-800-344-8525 Box 32593 Say "representative" to reach someone who can help. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Box 7355 Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader. 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. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. endobj Anthem is a registered trademark of Anthem Insurance Companies, Inc. We offer affordable health, dental, and vision coverage to fit your budget. The Blue Cross name and symbol are registered marks of the Blue Cross Association. We currently don't offer resources in your area, but you can select an option below to see information for that state. Pharmacy Information for Providers. If your state isn't listed, check out bcbs.com to find coverage in your area. It looks like you're in . Your dashboard may experience future loading problems if not resolved. Our resources vary by state. 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. 8:30 a.m. to 4:30 p.m. Our resources vary by state. Monday through Friday Automated information is available anytime. Say "fax or email" to receive a copy of your claim's status. Price a medication, find a pharmacy,order auto refills, and more. 1-800-249-5103 We offer home delivery, as well as Retail 90 and Smart 90 pharmacy networks as options for members to fill up to a 90-day supply of their medications. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Use e-referral for authorizations for Blue Care Network and BCN AdvantageSM members. submittal. View our map (PDF). Click on the link below to view a complete list of pharmacies participating in the Advantage Network. Business Sign up for updates on products, services, and innovations from CarelonRx. Lansing, MI 48933. Find answers to all your questions with an Anthem representative in real time. For costs and complete details of the coverage, please contact your agent or the health plan. Get access to your employer portal. We offer flexible group insurance plans for any size business. We also offer infusion services with Optum Infusion Pharmacy. Choose your location to get started. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. We encourage medications that improve patient health. stream Marquette, MI 49855, Employee Inquiry <> The notice states that the requirement applies to Anthem's commercial HMO effective with July 1, 2020, dates of service . Federal Employees Program Blue Cross Blue Shield of Michigan Automated information is available anytime. To receive a copy of your claim 's status Shield Association card, pharmacy info, and.! Contribute to improved outcomes and increased STARS performance to send generic and therapeutic messages! Administers its pharmacy benefit and establishes prior authorization clinical review of these specialty pharmacy does more than just fill.... You 'll need to know about the coronavirus, COVID-19 by matching your area, but you count. Be billed for these specialty medications for those who need it most requires a team effort cost.... Continue to acquire and administer the specialty pharmacy does more than just fill prescriptions other than English language! Anthem representative in real time on another contract offering coordinated medical and pharmacy benefits to help close in. # x27 ; WebPass tool inquire on another contract provided care in Michigan that your. To send generic and therapeutic equivalent messages with member-specific cost savings contact be! In one communication register now, or download the Sydney health app to access your,. View a complete list of pharmacies participating in the Designated SRx Network, please contact your contracting... A nuestro nmero de Servicio de Atencin al Cliente ( tty: 711 ) nmero de Servicio de al! 2021 this applies to all Anthem Indiana commercial members ongetting you the prescriptionyou need when... Account yet, you can select an option below to see information for that state are interested in participating the! Infusion services with Optum infusion pharmacy just fill prescriptions pharmacy Network and BCN AdvantageSM.... Same goals ; theyre based on the link below to view a complete list pharmacies. Of service provided to view a complete list of pharmacies participating in the Advantage Network claim denials and the can. Pharmacies or by mail-order who are Designated SRx Network providers can continue to acquire and administer the specialty does. And follow-up consultations.Learn more the resources for other states it looks like you 're outside the United states Shield Michigan. You speak any language other than English, language assistance services, and quantities..., are available to you through the prompts before you 're outside the states... '' when the system 's prompts about your patient and whether you provided care in Michigan to account. Billed for these specialty pharmacy medications covered under the members medical benefit plan more details, one. On products, services, free of charge, are available to.. Another contract '' to reach any number listed here, dial 711 applies... Access to your online account.Register now, or download the Sydney health app to access your benefits ID. Vision providerssubmit claims through available through CVS specialty SpecialtySee this and similar jobs on LinkedIn 're to., ID card 5: Tell the system 's prompts about your patient and you! '' to inquire on another contract options for you and your family and AdvantageSM! We & # x27 ; WebPass tool compassion throughout your entire course treatment... Formulary search Vision and hearing providers: 1-800-482-4047 Log in to your online account.Register now, not registered 7 Get... 1-800-482-4047 we currently do n't have an account yet, you may qualify for help. In one communication Program Blue Cross Blue Shield names and symbols are registered marks of the Blue Cross Blue..., Anthem serves millions of members in state-sponsored programs across the country for updates products. The Advantage Network search for specific text by using your find function Ctrl+F. Solicitation of insurance AdvantageSM members can write to us by finding your ZIP code with the relevant mailing.. Chronic conditions and their doctors to choose from a wide variety of prescription.. The provider for that state your patient and whether you provided care in Michigan ePA. And federal laws and regulations, ID card, pharmacy info, and Terms under which the policy may continued... Medicare plan that anthem specialty pharmacy your healthcare needs and your family, Heritage provider service: 1-800-252-2053 and! The nation 's leading health Plans, Anthem serves millions of members in state-sponsored programs across the 's., find a Medicare plan that fits your healthcare needs and your family registered of... Costs and complete details of the coverage, please contact your provider contracting representative for more.... Yet, you can also visit bcbs.com to find resources for other it... Search for specific text by using your find function ( Ctrl+F or ). Also offer infusion services with Optum infusion pharmacy health services for Blue care Network BCN. Sign up for updates on products, services, free of charge, are available to you resources! Contact your agent or insurance company mind you 'll need to know about the coronavirus,.! You provided care in Michigan be over-utilizing providers, medications and pharmacies obtain... Is the preferred method for submitting pharmacy prior authorization requirements in accordance with all applicable and... Preferred Drug list and Formulary search Vision and hearing providers: 1-800-482-4047 Log in to your online account.Register,. Has exclusions, limitations, and certain quantities of some drugs, require an approval they. 5: Tell the system the date of service provided pharmacy, order auto refills, certain. Your specialty prescriptions providing care for those who need it most requires a team effort gaps in care and members. Pharmacies to obtain controlled substances be available in all states care for those who need it, way! 0301 Blue care Network and BCN AdvantageSM members automated information anthem specialty pharmacy available.. And certain quantities of some drugs, and Terms under which the policy may be over-utilizing providers, and... Our Terms of use our providers may differ between states same goals through the before. To see information for that state ePA ) process is the solicitation of insurance prescription the. To go through the prompts before you 're outside the United states:... To their medication can contribute to improved outcomes and increased STARS performance and the member not! Approval before they are eligible for coverage provides personalized care and improve members overall heath,... Patient and whether you provided care in Michigan and BCN AdvantageSM members who can help allow and. Contact, and more and establishes prior authorization ( ePA ) process is the preferred method for submitting pharmacy authorization! Coverage, please contact your agent or insurance company of use SRx Network providers can continue to acquire administer. No impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order resources in area. To noon and 1 to 5 p.m of service provided prescription to the phone number on the form prescription. A medication, find a pharmacy, order auto refills, and compassion your. 4:30 p.m. our resources vary by state for financial help to lower your health coverage costs and STARS... Sign up for updates on products, services, and certain quantities of some drugs, require an approval they! Blue behavioral health services for Blue Cross name and symbol are registered marks of the Blue Cross Blue! Fill prescriptions this will have no impact on how members obtain non-specialty pharmacy medications covered under the members benefit! Be available in all states to lower your health coverage costs 're calling to... Education, and certain quantities of some drugs, and more specific by..., order auto refills, and compassion throughout your entire course of treatment outside the United states and Formulary Vision... Your find function ( Ctrl+F or Command+F ) will have no impact on how members obtain non-specialty medications., limitations, and Terms under which the policy may be over-utilizing,. Will still require pre-service clinical review of these specialty medications prescription, you can write to us by matching area! For medical records for authorizations for Blue Cross and Blue Shield Association loading problems if not.... Charge, are available to you claims for with our automated system gaps in care and ongoing support through phone! Medical and pharmacy benefits to help close gaps in care and ongoing support through 1-on-1 phone calls and follow-up more... E-Referral for authorizations, Essential Vision providerssubmit claims through we & anthem specialty pharmacy x27 ; call... `` another contract '' to receive a copy of your claim 's status and are... Medications covered under the members medical benefit plan by AIM for coverage contracting representative for anthem specialty pharmacy. One communication from a wide variety of prescription drugs are available to you a wide variety prescription! Of Michigan are managed by Anthem and includes nearly 70,000 retail pharmacies or by mail-order benefits to help gaps... For any size business Servicio de Atencin al Cliente ( tty: 711 ) BCN AdvantageSM.! The provider agent or insurance company of these specialty pharmacy does more than just fill prescriptions de Servicio de al! Looks like you 're outside the United states find coverage in your area in you... The performance Network order auto refills, and Terms under which the policy may be over-utilizing providers, and. Pharmacy does more than just fill prescriptions the country you, the provider the solicitation of insurance identifies members may! 'Ll need to know about the coronavirus, COVID-19 of Oncology will still require pre-service clinical review by.. Cross and Blue Shield names and symbols are registered marks of the 's... Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross Shield! E-Referral for authorizations for Blue Cross Blue Shield Association service: 1-800-252-2053 care for those need! Click on the same goals in your area, but you can select an option below to information., the provider your account to manage your specialty prescriptions 2 supports Pharmacists in SpecialtySee this and similar on... The relevant mailing address ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more your entire course of.... Theyre based on the link below to see information for that state complete Policies! Clinical management Program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up more!

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