Your health is important. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Lets look at the latest information on COVID-19 and how your health care plan can help. The best way to prevent infection is to avoid being exposed to the virus. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. 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. Yes, but coverage for testing varies by plan. Cost sharing will be waived for members using Anthems telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. Wash your hands or use hand sanitizer when entering their house or room. Anthem is committed to working with and supporting our contracted providers. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Findings. border-radius: 50%; Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. 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. If youd like additional support, please call the Member Services number on your member ID and ask for an Anthem Case Management Nurse. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. What codes would be appropriate for COVID-19 lab testing? Nevada Department of Health and Human Services Directors Office Urges Youth Screening (November 23, 2020), COVID-19 information from Anthem Blue Cross and Blue Shield Healthcare Solutions (October 22, 2020), Attention All Providers: New Phase 3 Provider Relief Funding Available (October 13, 2020), Deadline for Provider Relief Fund Has Been Extended to August 3, 2020 (July 23, 2020), HHS announces additional distributions from the Provider Relief Fund to eligible Medicaid and CHIP providers (6/15/2020), COVID-19 update: Guidance for telehealth/telephonic care for behavioral health services (June 9, 2020), Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment, COVID-19 update: Anthem Blue Cross and Blue Shield Healthcare Solutions suspends select prior authorization rules and announces significant policy adjustments in response to unprecedented demands on health care providers, Listen now! What Are Your Thoughts On The Vaccines Against Covid-19? Medicare Advantage and Medicare GRS plans are waived through February 28, 2021. cost sharing for telehealth services not related to the treatment of COVID-19 from Anthem's telehealth provider, LiveHealth Online, from March 17, 2020, through May 31, 2021, for our fully-insured employer, individual, and where permissible, Medicaid plans. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. cdc.gov/coronavirus/2019-ncov/about/index.html. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. In Indiana: Anthem Insurance Companies, Inc. FEP will also encourage members to use the 90-day mail order benefit, if available through your health plan.If you are having difficulty paying for your treatment, contact the retail pharmacy phone number on the back of your ID card for assistance. Do a video or phone visit with a doctor or therapist from home. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. COVID-19 testing remains an important part of keeping our families and communities safe. Does Anthem expect any slowdown with claim adjudication because of COVID-19? 132 0 obj <>/Filter/FlateDecode/ID[<7A556C2107D3FE4287A53DF79E9C5AC9><793C7E08A7A7684290861DE5BB023FB8>]/Index[111 45]/Info 110 0 R/Length 106/Prev 205504/Root 112 0 R/Size 156/Type/XRef/W[1 3 1]>>stream COVID-19 vaccines for youth toolkit available. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). None of these drugs is approved for use with COVID-19, and many are still being investigated. Call us at 888-832-2583 to explore your options. Good health habits can also help prevent and fight COVID-19. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. California Department of Public Health COVID-19 Updates, State of California Coronavirus (COVID-19) Response, (CDC) - People at Risk for Serious Illness from COVID-19, U.S. Department of State, Travel Advisories, World Health Organization (WHO), Coronavirus, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), vaccination prevents severe illness, hospitalizations, and death, cdc.gov/coronavirus/2019-ncov/about/index.html. Prior authorization is not required for COVID-19 testing. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Waiving cost-sharing for COVID-19 testing and treatment. No, prior authorization is not required for diagnostic services related to COVID-19 testing. Anthem does not cover telephonic-only services today (with limited state exceptions) but we are providing this coverage effective from March 19, 2020, through January 11, 2023, to reflect the concerns we have heard from providers about the need to support continuity of care for Plan members during extended periods of social distancing. 0 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. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. How can I find a COVID-19 testing location? View insurance accepted, education, awards, and specialties for NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. Every day, use household cleaner to wipe the surfaces of frequently-used equipment or devices. Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated . Reimbursement for COVID-19 testing performed in a participating hospital emergency room or inpatient setting is based on existing contractual rates inclusive of member cost share amounts waived by Anthem. If it doesnt, we can talk about your options. Arrive in 2 to 5 business days. The over-the-counter tests give results within 30 minutes. Click below for the latest information for providers: The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the Novel Coronavirus (COVID-19) pandemic. In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan's network. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. We're here to make sure you have the resources and care you need to keep yourself safe and well. margin-bottom: 40px; What financial assistance is available for care providers during the COVID-19 crisis? If an in-network provider is not reasonably available, the cost share waivers will include testing or screening for COVID-19 when received from an out-of-network provider. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. In addition to Availity.com, providers and state agencies who wish to submit Roster Billing claims can submit paper forms: Is there a specific diagnosis code Anthem would look for on the COVID-19 Vaccination Roster Billing Form? What is the best way that providers can get information to Anthems members on Anthems alternative virtual care offerings? 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. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. 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. Providers who currently submit electronic claims are encouraged to do so. Do you have medicines you take regularly? padding: 0.6rem; Commercially insured members: 1-888-624-3096, Members covered through Medicaid plans: 1-800-711-5952, SHBP/SEHBP members: 1-800-414-SHBP (7427), Horizon Chat for Care may be available to some members at no cost through the companys free Horizon Blue app and. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. To help reduce the burden on the states health care facilities and ensure members get the care they need when they need it, the cost-sharing waiver also applies totelemedicine visits, includingtelephonic visits. You may also receive a bill for any charges not covered by your health plan. If you are, youll be able to place an order. cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. Effective from March 19, 2020, through May 31, 2021, unless a longer period is required by law, Anthem will cover telephone-only medical and behavioral health services from in-network providers and out-of-network providers when required by state. Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Clean and disinfect items and surfaces you touch . FEP will waive copays for all virtual doctor visits by Teladoc during this time. Please review the Medicare and Medicaid specific sites noted below for details about these plans. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. ET. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. And let them know if youve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. div.treatment-testing-cont div.motif-icon.motif-marker:before { endstream endobj startxref Can I visit the emergency room for a test? Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. Schedule a COVID-19 test with your doctor. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. Serving California. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. 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). The health of our members is always our top priority. Check the. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. In Ohio: Community Insurance Company. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? We have resources and partners to help you handle not just everyday needs, but extra ones you may be facing in this outbreak. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. Only visit the ER or call 911 if you're experiencing life-threatening symptoms. In addition, Anthem will waive member cost shares for a limited set of remote monitoring codes (99453, 99454, 99457, or 99091) with in-network providers for visits coded with POS 02 and modifier 95 or GT. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. div.treatment-testing-cont div.motif-icon.motif-user-male-circle:before, . The cost-sharing waiver includes copays, coinsurance and deductibles. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Update your email address and choose the email option under Helpful Information to stay informed on COVID-19. Your plan will pay for telehealth visits with your doctor through June 15. From March 17, 2020, through September 30, 2020, Anthems affiliated health plans waived member cost shares for telehealth visits for services not related to the treatment of COVID-19 from in-network providers, including visits for behavioral health, for insured health plans in Colorado under this guidance, including our fully-insured employer plans, individual plans and health savings account-qualified high deductible health plans (HSA-HDHPs). Need coverage now due to job loss? Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. 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. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. Otenti said if someone has been near a person with COVID-19 within a two-week time frame, there is also good reason to test for the virus . When are COVID-19 tests covered? Effective March 17, 2020, through September 30, 2020, unless a longer period is required by law, Anthems affiliated health plans will waive member cost share for telehealth (video + audio) in-network visits, including visits for behavioral health, for our fully-insured employer plans and individual plans. How does my plan cover the over-the-counter test? Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. The DHCFP is asking for Nevada Medicaid providers to assist with providing these flyers to Nevada Medicaid recipients. This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. The guidance here can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)-contracted laboratories and identify the proper CPT codes to use. 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. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. Serving residents and businesses in the 28 eastern and southeastern counties of New York State. As an Anthem member, you have access to a wide range of online resources to help you and your family members address emotional health and life challenges. CDC information for household members and caregivers can be found here. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? What codes would be appropriate to consider for telehealth (audio and video) for physical, occupational, and speech therapies? Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? In addition, Anthems telehealth provider, LiveHealth Online, is another safe and effective way for members to see a physician to receive health guidance related to COVID-19 from home via a mobile device or computer with a webcam. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. For more information, view our privacy policy. CMS has provided coding guidelines related to COVID-19 vaccines:https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies. Telemedicine not only helps members get the care they need, but helps reduce the spread of the coronavirus protecting the health of our members and the doctors and nurses who care for them. As the number of COVID-19 cases in New Jersey moves in the wrong direction, Horizon Blue Cross Blue Shield of New Jersey will continue to do whats right for our members and communities. 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. An attending health care provider may order a test. What diagnosis codes would be appropriate to consider for a patient with known or suspected COVID-19 for services where a members cost shares are waived? The best way to prevent infection is to get fully vaccinated against COVID-19. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. This is also for . Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. 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. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. For full details onbenefits, services and network coveragewhich may vary by health planfind each BCBS companys statement below: The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. You do not need a doctors order for the over-the-counter diagnostictest. The protection of your privacy will be governed by the privacy policy of that site. No. COVID-19 testing remains an important part of keeping our families and communities safe. 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. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. In Kentucky: Anthem Health Plans of Kentucky, Inc. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. We use cookies on this website to give you the best experience and measure website usage. Do these guidelines apply to members enrolled in the Blue Cross and Blue Shield Service Benefit Plan commonly referred to as the Federal Employee Program (FEP) through the Federal Employees Health Benefits Program? When member cost sharing has been waived (where permissible) by Anthem as outlined in this FAQ for COVID-19 testing and visits associated screening and/or tested for COVID-19, telehealth (video + audio) services, and in-network telephonic-only services, how does that impact provider reimbursement? It lets you see a doctor through live chat or video on your phone, tablet, or computer. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Will Anthem allow Roster Billing for the COVID-19 vaccine? 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. At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. In general, it is recommended people get tested if they have symptoms including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat. *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. Here are some tips: Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. For telehealth services rendered by a facility provider, report the CPT/HCPCS code with the applicable revenue code as would normally be done for an in-person visit, and also append either modifier 95 or GT. In Maine: Anthem Health Plans of Maine, Inc. At-home test kits from Anthem: Are FDA-authorized. 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. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. Get Reimbursed for Over-the-Counter COVID-19 Tests. Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. Find free and reduced-cost support for food, transportation, housing, health and more. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Eligible members can find an in-network doctorhereor access HorizonCareOnline through the Horizon Blue app,www.horizoncareonline.com, orwww.HorizonBlue.com. For members who arent feeling well, telehealth services are available so you can get care at home. If your doctor isnt available for some reason, well help you find alternate care. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. www.cdc.gov/coronavirus. cost sharing for COVID-19 diagnostic tests as deemed medically necessary by a healthcare clinician who has made an assessment of a patient, including serology or antibody tests, for members of our employer-sponsored, individual, Medicare and Medicaid plans. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. Leading the way in health insurance since 1929. You may also receive a bill for any charges not covered by your health plan. Please check the CDC for the most up-to-date list of symptoms. Participating hospitals without lab fee schedules will follow the same lab testing reimbursement as defined in their facility agreement with Anthem inclusive of member cost share amounts waived by Anthem. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. 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. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Providers should continue to verify eligibility and benefits for all members prior to rendering services. We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. Ordering at-home test kits from Anthem. Hyperlink reference not valid.. Anthem also looks for the CS modifier to identify claims related to evaluation for COVID-19 testing. Please review the terms of use and privacy policies of the new site you will be visiting. To learn where you can obtain a test visit the State of New Jerseys. Please log in and update your communication preferences to make sure you receive the latest information. color: #ffffff; Today, unless otherwise required under state and federal mandates as detailed below, Anthem health plans will suspend select prior authorization (PA) requirements, member cost sharing, claims review and handling protocols to allow health care providers to focus on caring for patients diagnosed with COVID-19: We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Call the National Information Center weekdays from 8 a.m. to 8 p.m. Independent licensees of the Blue Cross and Blue Shield Association. 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. Reimbursement is available only during the COVID-19 public health emergency. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Cdc approved vaccines as they become available can assist them with symptoms that are consistent with COVID-19. Pay no Member cost share for LiveHealth Online others, avoiding crowds and poorly spaces! On a regular basis from a 30-day supply role in their health an active in... Codes would be appropriate to consider for telehealth ( audio and video ) for physical,,. 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