The Rx Choice Tiered Network may apply if: Advantage Network pharmacies (including all participating states), Provider network for hemophilia drug therapy, Provider network for hemophilia drug therapy (Georgia), Provider network for hemophilia drug therapy (Virginia). Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. Box 33248 Business Sign up for updates on products, services, and innovations from CarelonRx. Pharmacy Information for Providers We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. New Directions. 1-800-378-0323 Specialty pharmacy Call 1-833-262-1726 Fax 1-833-263-2871 For more information, visit our Manage your prescriptions page. In Maine: Anthem Health Plans of Maine, Inc. 8 a.m. to noon and 1 to 5 p.m. Or There's no more critical person on this team than you, the provider. 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. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Anthem ( NYSE: ANTM ) is one of the largest managed care organizations in the United States. If you need additional guidance, read the Dentaquest Dental Manual (PDF). 8:30 a.m. to 6 p.m. You can even get reminders when you need a refill. In Kentucky: Anthem Health Plans of Kentucky, Inc. We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. Members have one vendor, one contact, and one ID card. You can write to us by finding your ZIP code with the relevant mailing address. Get access to your employer portal. Help for members impacted by the winter storms emergency in California, March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, June 2020 Anthem Blue Cross Provider News - California, 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. Attention: Claim Processing Click on the link below to view a complete list of pharmacies participating in the Performance Network. You can also talk to your provider consultant. Our automated interactive voice response system provides claims, benefit and cost-share information. 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. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. 1-800-822-2761 Understand your care options ahead of time so you can save time and money. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Specialty medications are used to treat these conditions and often require special storage or extra support. submittal. Blue Cross Blue Shield of Michigan 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. We see how drugs work in our members real lives and help them make good health care choices. It can also send you a copy of your claim's status. Register Now, Not registered? There are some things in life that we depend on. 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. We provide health insurance in Michigan. 711. endobj 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. If your state isn't listed, check out bcbs.com to find coverage in your area. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. The Pharmacy Home Program identifies members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances. You can also visit. Hospitals or facilities: 1-800-249-5103 Available for iOS and Android devices. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. 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. P.O. Find yours in our list ofphysician organization consultants (PDF). 8:30 a.m. to 4:30 p.m. You get your health insurance plan from an employer or if you have certain grandfathered plans. You can use our automated system to reach a representative to discuss your claim's outcome. To report fraud, waste or abuse, call our hotline: 1-800-437-3803 For costs and complete details of the coverage, please contact your agent or the health plan. % Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. 20500 Civic Center Drive IngenioRx* is the pharmacy benefits manager. Use of the Anthem websites constitutes your agreement with our Terms of Use. Monday through Friday, Care Management--Mail Code C355 Log in at availity.com. Monday through Friday. Both medical and pharmacy costs are our responsibility. Physicians and professionals: 1-800-344-8525 We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. CarelonRx is the pharmacy benefits manager (PBM) for Anthem HealthKeepers Plus members in Virginia. Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. 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. You'll need to use e-referral for Medicare Plus Blue authorization requests. 1-800-249-5103 1-844-876-7917 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. Creating an account is free, easy and helps patients get their medications sooner. All you need to know about the COVID-19 vaccines and boosters.Get the details. Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. Step 6:Tell the system the total amount charged. Grand Rapids, MI 49523-0589, Provider Inquiry Your browser is not supported. Manage your medicine from anywhere with the Anthem mobile app With the free app, you can: Order refills Track orders View all prescriptions Download the app now: Page Last Updated: 06/09/21 Marquette, MI 49855, Employee Inquiry Your dashboard may experience future loading problems if not resolved. Say "claims" when the system asks why you're calling. Look for these symbols in the pharmacy listings: Pharmacy search tips: Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Monday through Friday 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. Box 230589 We engage members and you, their doctors. 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. Whether you need to check on a claim, pay a bill, or talk to a representative, you can easily access all your member features. 8 a.m. to 4 p.m. Facility and Special Programs Step 4: Say "no" when asked if you have additional questions about the determination of a claim. We send members personalized messages about medications that may reduce their costs and include specific cost savings. Vision providers who can't access their account or need more information can read the Blue Vision Provider Summary Guide (PDF) to learn how to: Submit claims, appeals and attachments Specialty pharmacies have highly trained pharmacists and nurses to provide personal care and guidance to help you manage your condition. It looks like you're outside the United States. Your online account is a powerful tool for managing every aspect of your health insurance plan. 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. Here to Help You. See what specialty pharmacies are considered in-network. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. P.O. Blue Cross Blue Shield of Michigan Monday through Friday, Care Management--Mail Code C355 If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. 4 0 obj The Blue Cross name and symbol are registered marks of the Blue Cross Association. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. stream Step 5: Tell the system the date of service provided. CVS Specialty helps patients with complex conditions manage their medications and live their best lives. 1 0 obj 8 a.m. to 7 p.m. As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. Refill and track your specialty drug prescriptions, pay online, and get live support. CVS Specialty makes living with your condition easier. Say "another contract" to inquire on another contract. If specialty medications are obtained through other pharmacies, the claim will be denied. Choose your location to get started. Blue Cross Blue Shield of Michigan. 1-844-396-2329 (TTY 711). Detroit, MI 48231-2599, Blue Cross Complete claims Detroit, MI 48232-0593, UB-04 claims Taking time for routine mammograms is an important part of staying healthy. Physicians and professionals: 1-800-344-8525 Monday through Friday, 1-800-431-1059 If you don't have an account yet, you can check claims for with our automated system. View listings below of the retail pharmacies that participate in our pharmacy networks. Hospitals or facilities: 1-800-249-5103 Federal Employee Program providers and facilities: 1-800-840-4505. The resources for our providers may differ between states. 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. Southfield, MI 48075, 1-877-293-2788 Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. 8 a.m. to noon and 1 to 5 p.m. Find a Participating Pharmacy in Your Area. L07B Everything we do centers ongetting you the prescriptionyou need, when you need it,your way. We currently don't offer resources in your area, but you can select an option below to see information for that state. You can also use these documents for guidance: Have your NPI, Tax ID or Social Security number ready before calling. 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. You can count on our guidance, education, and compassion throughout your entire course of treatment. The purpose of this communication is the solicitation of insurance. Contact customer service, Heritage Provider service: 1-800-252-2053. The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. To comply with Anthems programs related to the management of pharmacy expenses, providers will be required to obtain specialty pharmacy medications administered in the office or outpatient hospital setting through CVS Specialty effective July 1, 2020. Drugs used for the treatment of Oncology will still require pre-service clinical review by AIM. Lets make healthy happen. 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. If you're a provider who needs to contact us about one of our Blue Cross Blue Shield of Michigan, Blue Care Network or our Medicare products, start here. Step 6: Tell the system the total amount charged. Scroll down and select Pharmacy in the Category drop down. One Woodward Avenue, Suite 2020 Pay outstanding doctor bills and track online or in-person payments. Preferred Drug List and Formulary Search Automated information is available anytime. You can write to us by matching your area code with the relevant mailing address. Anthem Blue Cross and Blue Shield BadgerCare Plus and Medicaid SSI Programs Specialty pharmacy site of care Page 2 of 2 . 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. 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. If you have questions, please contact your group administrator or your Anthem network representative. Medical Prior Authorization requests can be submitted through CoverMyMeds. Box 7355 Step 6: You will then be transferred to the servicing center for assistance. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. There, you can log in to refill, manage, and sign up for home delivery. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. Note: The FEP phone system has a different set of prompts than the others. Step 2: Answer the prompts about your patient and whether you provided care in Michigan. Compare plans available in your area and apply today. x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ 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. 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. Register Now, Not registered? 1-888-803-4960 Box 68710 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. In Ohio: Community Insurance Company. Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan This applies to all Anthem Indiana commercial members. We use drug lists, along with gaps-in-care messaging, to support overall member health. If youre a professional provider office, you have access to a provider consultant. 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. Featured In: Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. Our medical and pharmacy experts work collaboratively. Not registered? 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. Essential Vision providerssubmit claims throughHeritage Vision Plan. Don't have a secured provider portal account yet? If you misplace your medicine or it is stolen, contact your provider. Pharmacy Information for Providers. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. In Indiana: 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. Register Now, Learn more about registering for our web tools. 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 resources on this page are specific to your state. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). It can also send you a copy of your claim's status. IngenioRx Specialty Pharmacy provides your specialty medications. 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. 1-800-482-4047 The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. P.O. The automated system is available anytime. 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. Just keep in mind you'll need to go through the prompts before you're connected to someone. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. If you call before 30 days, we may not be able to check your claim through our automated phone system. If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. Your browser is not supported. Box 312599 You can also visit. A specialty pharmacy does more than just fill prescriptions. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. 8 a.m. to 5 p.m. The notice states that the requirement applies to Anthem's commercial HMO effective with July 1, 2020, dates of service . Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. Search for specific text by using your Find function (Ctrl+F or Command+F). 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. Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. Vision and hearing providers: 1-800-482-4047 ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Explore our comprehensive guides and video resources for more information regarding your condition. Detroit, MI 48232-4248, Provider Inquiry 1-800-344-8525 Choose your location to get started. We look at claims data to find opportunities for our members to save money by switching them to lower-cost, therapeutically equivalent drugs. You can find yours by selecting your region: Not sure which region you're in? Hospitals or facilities: 1-800-249-5103. And to help ensure coordination of care and compliance, physicians also receive a consolidated communication with similar messages. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. 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. P.O. 8:30 a.m. to noon and 1 to 5 p.m. If you're not a Blue Vision provider, send claims to: VSP We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. A specialty pharmacy does more than just fill prescriptions. Get the mobile app 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. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. Register Now, Not registered? Monday through Friday It looks like you're in . 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. Our resources vary by state. Physicians and professionals: 1-800-344-8525 42I]?evMJz8q9|eszwdZL9}owq1}s&,/K{IP,xW^.` The resources for our providers may differ between states. 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. Individuals attempting unauthorized access will be prosecuted. We look forward to working with you to provide quality service for our members. You can count on our guidance, education, and compassion throughout your entire course of treatment. Get access to your agent portal. The automated system is available anytime. Step 1: Say "claims" when the system asks why you're calling. Monday through Friday. Explore programs available in your state. Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? London, KY 40742. 20500 Civic Center Drive Grand Rapids, MI 49516-8710, BCN Advantage Claims Detroit, MI 48231-0166, Federal Employee Program claims Please update your browser if the service fails to run our website. View our map (PDF). Use our app, Sydney Health, to start a Live Chat. 3 0 obj If you don't have an account yet, you can check claims for BCBSM patients with our automated system. Blue Cross Blue Shield of Michigan Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. You can also visit bcbs.com to find resources for other states. When you email us, we'll call . Automated information is available anytime. 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). Please call Accredo at 1-844-433-4878 or visit 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. You can order by phone whether or not you're already a member. Say "representative" to reach someone who can help. Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. Search for specific text by using your Find function (Ctrl+F or Command+F). Choose your state below so that we can provide you with the most relevant information. Blue Care Network Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. It looks like you're outside the United States. Important informationabout your 1095-B form. Some drugs, and certain quantities of some drugs, require an approval before they are eligible for coverage. Once we identify a gap in care, the member receives a personalized Medication Review, which contains pharmacy messaging for our clinical and cost-of-care programs in one consolidated, health plan-branded, monthly member communication. 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). P.O. If youre an administrative office of a medical care group, you have access to a professional organization consultant. Learn more. Step 5: Tell the system the date of service. Pharmacy Information and Tools. Price a medication, find a pharmacy,order auto refills, and more. Plus, you may qualify for financial help to lower your health coverage costs. Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. Find a Medicare plan that fits your healthcare needs and your budget. Blue Vision providers submit claims electronically directly toVSP. The automated system is available anytime. Providing care for those who need it most requires a team effort. 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. 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. What you need to know about the coronavirus, COVID-19. R-300913DescriptionThe Specialty Operations Pharmacy Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn. We help you find the lowestprices for the most effectivemedication. If you no longer qualify, we can connect you to the right options for you and your family. Find out if your medication is available through CVS Specialty. 1-877-258-0167 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. Understand your care options ahead of time so you can save time and money. 8:30 a.m. to noon and 1 to 5 p.m. A specialty pharmacy does more than just fill prescriptions. Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. 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. Blue Cross Blue Shield of Michigan Specialty Pharmacy Benefits | Anthem Blue Cross Blue Shield Nevada Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different.