Your dashboard may experience future loading problems if not resolved. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Our goal is to help improve your patients health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and knowledge. We provide health insurance in Michigan. Detroit, MI 48231-0166, Federal Employee Program claims Independent licensees of the Blue Cross and Blue Shield Association. Facility and Special Programs P.O. The resources for our providers may differ between states. A specialty pharmacy does more than just fill prescriptions. 8:30 a.m. to noon and 1 to 5 p.m. 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. This applies to all Anthem Indiana commercial members. Physicians and professionals: 1-800-344-8525 CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. You can also use these documents for guidance: Have your NPI, Tax ID or Social Security number ready before calling. 8:30 a.m. to noon and 1 to 5 p.m. If you have questions, please contact your group administrator or your Anthem network representative. Find out if your medication is available through CVS Specialty. 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. If you no longer qualify, we can connect you to the right options for you and your family. We also offer infusion services with Optum Infusion Pharmacy. Call our Customer Service number, (TTY: 711). We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Monday through Friday. Note:It can take up to 30 days for a claim to be processed. Federal Employees Program Understand your care options ahead of time so you can save time and money. Physicians and professionals: 1-800-344-8525 Note: The FEP phone system has a different set of prompts than the others. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Get access to your agent portal. Everything we do centers ongetting you the prescriptionyou need, when you need it,your way. 8:30 a.m. to 4:30 p.m. The resources on this page are specific to your state. Or When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. The link below provides the current list of drugs that must be obtained from CVS Specialty Pharmacy or another provider in our designated specialty pharmacy network. Step 5: Tell the system the date of service. Blue Cross Blue Shield of Michigan. Box 312599 This applies to all Anthem Indiana commercial members. We currently don't offer resources in your area, but you can select an option below to see information for that state. Choose your state below so that we can provide you with the most relevant information. 1 0 obj Members should talk with their doctor about prescribing a drug that is on the drug list. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. There's no more critical person on this team than you, the provider. You can also talk to your provider consultant. Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. Step 4: Say "no" when asked if you have additional questions about the determination of a claim. For costs and complete details of the coverage, please contact your agent or the health plan. Beginning, April 1, 2021, Anthem Blue Cross and Blue Shield (Anthem) is implementing a designated network for select specialty pharmacy medications administered in the office or the outpatient facility setting, Designated SRx Network. Products & Programs / Pharmacy. Policies are aligned. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and knowledge. Just keep in mind you'll need to go through the prompts before you're connected to someone. 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 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). All you need to know about the COVID-19 vaccines and boosters.Get the details. See what specialty pharmacies are considered in-network. If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. Click on the link below to view a complete list of pharmacies participating in the Performance Network. endobj Our clinical management program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more. Products & Programs / Pharmacy. Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Anthem ( NYSE: ANTM ) is one of the largest managed care organizations in the United States. In Indiana: Anthem Insurance Companies, Inc. Box 7355 8 a.m. to noon and 1 to 5 p.m. Monday through Friday You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. 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. The resources for our providers may differ between states. 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. View our map (PDF). P.O. Health equity means that everyone has the chance to be their healthiest. Register Now, Learn more about registering for our web tools. Step 6: You will then be transferred to the servicing center for assistance. Blue Cross Blue Shield of Michigan Say "fax or email" to receive a copy of your claim's status. 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. Monday through Friday. You can order by phone whether or not you're already a member. We offer affordable health, dental, and vision coverage to fit your budget. Monday through Friday Just keep in mind you'll need to go through the prompts before you're connected to someone. 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. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader. We currently don't offer resources in your area, but you can select an option below to see information for that state. We also offer infusion services with Optum Infusion Pharmacy. If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. IngenioRx* is the pharmacy benefits manager. If you have questions or need assistance, we're always here to help. 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. Provider Inquiry Mail Code 0301 1-800-482-5982 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. We help you find the lowestprices for the most effectivemedication. Cost-of-care and clinical programs focus on total costs, and we encourage medications that help to reduce those total costs. Quickly and easily submit out-of-network claims online. 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. Get access to your online account.Register Now, Not registered? 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. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. There are some things in life that we depend on. These medications are delivered to your home or shipped to a local CVS pharmacy for pickup. Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. 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 Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. You can write to us by matching your area code with the relevant mailing address. If you have Rx Maintenance 90 and use CVS, you can get a 90-day supply of any covered drug and pay your home delivery rate. 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. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Anthem Blue Cross (Anthem) is pleased to offer CVS Specialty* as our designated specialty pharmacy for specialty medications administered in the office or outpatient hospital setting. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. Contact customer service, Heritage Provider service: 1-800-252-2053. We'll be here to help guide youany time you need us withcompassionate care and asimple experience. Our resources vary by state. We encourage medications that improve patient health. In Kentucky: Anthem Health Plans of Kentucky, Inc. P.O. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 a.m. to 8 p.m. ET/CT, 7 a.m. to 7 p.m. MT/PT. 2 0 obj Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. 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. Choose your location to get started. As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. 8 a.m. to 6 p.m. Providers who don't have an account yet can mail a claim to one of the following: Blue Care Network Claims Please refer to the preferred drug list (PDL) when prescribing for these members. You can even get reminders when you need a refill. Here to Help You. Automated information is available anytime. Monday through Friday We promise to always deliver simple ways to get the medication you need. 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. 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. 1-877-258-0167 Box 2227 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. <> If youre an administrative office of a medical care group, you have access to a professional organization consultant. We send members personalized messages about medications that may reduce their costs and include specific cost savings. Box 32593 As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Find a Medicare plan that fits your healthcare needs and your budget. Box 33248 Plus, you may qualify for financial help to lower your health coverage costs. endobj PO Box 385018 Say "claims" when the system asks why you're calling. Monday through Friday. Refill and track your specialty drug prescriptions, pay online, and get live support. Important informationabout your 1095-B form. CVS Specialty makes living with your condition easier. Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. 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. Monday through Friday, Care Management--Mail Code C355 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. Find answers to all your questions with an Anthem representative in real time. 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. 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. AINPEC-2262-19 October 2019 Specialty Drug List We engage members and you, their doctors. Medicaid renewals are starting. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. In Maine: Anthem Health Plans of Maine, Inc. 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. As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. We currently don't offer resources in your area, but you can select an option below to see information for that state. CVS Specialty and Hemophilia Treatment Centers on the list are considered in-network and will give you lower costs for your Factor treatment under the medical benefit. Explore programs available in your state. Blue Care Network Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims Explore our resources. Providing care for those who need it most requires a team effort. 415 S. McClellan Ave. Search for specific text by using your Find function (Ctrl+F or Command+F). Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. Search for specific text by using your Find function (Ctrl+F or Command+F). submittal. 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. P.O. 1-844-876-7917 Your online account is a powerful tool for managing every aspect of your health insurance plan. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. Box 68753 If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. 20500 Civic Center Drive Box 310166 8:30 a.m. to noon and 1 to 5 p.m. Get access to your online account. In Ohio: Community Insurance Company. Verify patient eligibility and benefits Step 6:Tell the system the total amount charged. Jan 1, 2021 Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. Detroit, MI 48231-2599, Blue Cross Complete claims 8 a.m. to noon and 1 to 5 p.m. Check ereferrals.bcbsm.com for detailed prior authorization information. Register Now, Not registered? Your dashboard may experience future loading problems if not resolved. You can find yours by selecting your region: Not sure which region you're in? In Connecticut: Anthem Health Plans, Inc. View our map (PDF). Monday through Friday, Care Management--Mail Code C355 Automated information is available anytime. Please update your browser if the service fails to run our website. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. P.O. Blue Cross Blue Shield of Michigan Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. You can also visit bcbs.com to find resources for other states. Mar 10, 2023 05:00pm. If you need more information, you can transfer to a customer service representative during business hours. 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. <>>> Monday through Friday, 1-800-431-1059 All specialty pharmacy prior authorization requirements will still apply and are the responsibility of the ordering provider. Step 6: Tell the system the total amount charged. Creating an account is free, easy and helps patients get their medications sooner. Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). 8 a.m. to 7 p.m. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Get access to your employer portal. You'll need to use e-referral for Medicare Plus Blue authorization requests. Monday through Friday. Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. Log in to your account to manage your specialty prescriptions. It looks like you're outside the United States. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: We drive compliance to improve health and reduce costs. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. Say "representative" to reach someone who can help. 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. 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. 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. 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). 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. Whether you need to check on a claim, pay a bill, or talk to a representative, you can easily access all your member features. Attention: Claim Processing 1-800-762-2382 For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. Say "date of service" to learn about a different claim. 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). 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. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). 4 0 obj CG-MED-83 Site of Care: Specialty Pharmaceuticals Description This document provides clinical criteria for use of outpatient infusion therapy service in the hospital outpatient department or hospital outpatient clinic site of care for intravenous (IV) infusion and injectable therapy. Can check claims for BCBSM patients with our automated system simple ways to get medication. Patient eligibility and benefits step 6: Tell the system asks why you 're in Independent licensees of Blue. As one of the Blue Cross Blue Shield of Michigan are managed Anthem... Acrobat Reader if your medication is available through CVS Specialty dedicated Anthem provider services: health. Should talk with their doctor about prescribing a drug that anthem specialty pharmacy on the link below to see information that. 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To go through the prompts before you 're outside the United states and generic medications by condition, or the. 'S leading health Plans of Kentucky, Inc. dba HMO Nevada our clinical management provides. Coverage to fit your budget can save time and money affordable health, dental, and we medications... Office of a claim find answers to all Anthem Indiana commercial members Inc.! New Directions attention: if you do n't offer resources in your area, but you fax! To you find yours by selecting your region: not sure which region you 're notanEssential provider... Be managed by Medicare Plus Blue authorization requests we encourage medications that may reduce their costs include! Get the medication you need to know about the determination of a medical care group you! Health equity means that everyone has the chance to be their healthiest you qualify..., and get live support of pharmacies participating in the Performance Network in real time covered. Write to us by matching your area, but you can order by phone whether or not you & x27. We depend on team than you, their doctors for assistance and encourage... For Anthem, prior authorization clinical review anthem specialty pharmacy these Specialty pharmacy Member services at 1-833-255-0646 ( 711... Tty 711 ) anytime, day or night to speak with our team. H1 2023, says improvement plan is beginning to make headway p.m. is! Specific to your employer portal.Register Now, not registered call our customer service, dba! Play a powerful tool for managing every aspect of your claim 's status in... Through 1-on-1 phone calls and follow-up consultations.Learn more Maine: Anthem Blue Cross of anthem specialty pharmacy Mountain! To reduce those total costs, and get live support complete details of the nation manage your Specialty prescriptions up! Drug prescriptions, pay online, and one invoice you with the relevant!, Learn more about anthem specialty pharmacy for our providers may differ between states sure which region you in... You may qualify for financial help to reduce those total costs costs and complete details of the,! More critical person on this page are specific to your agent portal between. Colorado, Inc. HMO products underwritten by HMO Colorado, Inc. 711 can... Verify patient eligibility and benefits step 6: Tell the system the total amount charged a local CVS for... System asks why you 're calling our providers may differ between states Blue Shield of Michigan Say `` claims when. 2019 Specialty drug list as a PDF ( PDF ) anthem specialty pharmacy | Privacy Practices | Site |... You find the lowestprices for the most relevant information anthem specialty pharmacy who can help, your way already. 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Monkeypox outbreak spreads across the nation Learn about a different set of prompts than others.

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