Be sure to log in and check your communication preferences. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. That includes older adults, people living with disabilities, and those with chronic medical conditions like diabetes, and heart, lung or kidney disease. hk%@Z^ pp>ZV]X~ fE#E2y$IFD*r\Rtk^u_e,~tIG*aJ*h'URWjRJ=W*L)CCCBTjJ4Oo~x|~y|?x~|.o._=w_~w_{?G=o1q}w?\ZNwuw?Kw|/vCyvIY7?}Ngw}&UG-&F-w_=_,_=aUq+uK[W--kVtkKU=V5|Zq:4o]{u\Z-UCC5PqiU#]Eyfk]WJnv?/u]s9n'#~rk]f2x7-,}_[-mjeh5j7 o~L}5wQVeu,OkA4oSS3.U Visit your member website for information on how your health plan covers COVID-19 testing. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Payment for COVID-19 testing services on or after January 1, 2022. Type at least three letters and we will start finding suggestions for you. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Only visit the ER or call 911 if you're experiencing life-threatening symptoms. Serving California. 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. Member Discounts Take advantage of member-only discounts on health-related products and services. Tell them if youve been in close contact with a person who has COVID-19, or if you live in or have been to an area where the virus has spread. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Pain or pressure in the chest that wont go away. Were sharing information about how you can protect yourself and the people you care about. 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. 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. You can even get them through home delivery pharmacy. Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. Please review the terms of use and privacy policies of the new site you will be visiting. The Department would like to bring to your attention the importance of the role you play as a provider in mental health screening and early identification of mental and behavioral health difficulties. In Ohio: Community Insurance Company. .treatment-testing-cont:nth-child(2) { This is also for . This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. Administration for Community Living: COVID-19 and what you need to know, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), You can still use in-person diagnostic COVID-19 testing sites. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? 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? During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them: Effective March 20, 2020, hydroxychloroquine and chloroquine prescriptions will require a diagnosis code on the prescription. Please check the CDC for the most up-to-date list of symptoms. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Each state will decide how and when to distribute vaccines. Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. What you need to know about the disease and our coverage commitment. . 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. 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. In Connecticut: Anthem Health Plans, Inc. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. 111 0 obj <> endobj You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Blue Shield of California and Blue Shield of California Promise Health Plan are independent licensee s of the Blue Shield Association L52000-W-BSC-PHP (1/20) T11597 (4/21) Page 1 of 5 . Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. 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? See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. Check the. If you cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. Anthem is committed to making sure you can get the care you need. 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. Taking care of your emotional health is important during this stressful time. Our standard health plan contracts do not have exclusions or limitations on coverage for services for the treatment of illnesses that result from a pandemic. 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. Blue Shield and Blue Shield Promise will cover most COVID-19 tests at no out-of-pocket cost to you for specified plans noted below. According to the CDC, vaccination prevents severe illness, hospitalizations, and death. endstream endobj 112 0 obj <>/Metadata 8 0 R/Pages 109 0 R/StructTreeRoot 23 0 R/Type/Catalog/ViewerPreferences 133 0 R>> endobj 113 0 obj <>/MediaBox[0 0 612 792]/Parent 109 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 114 0 obj <>stream Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. For non-COVID-19 tests (like flu, RSV, etc.) This modifier should be used for COVID-19 evaluation and testing services in any place of service. Cant reach your doctor? Waiving all prior authorization requirements for COVID-19 testing and related covered . Johns Hopkins University has resources to help you learn more about the disease. Lets look at the latest information on COVID-19 and how your health care plan can help. To access your member services, please visit your BCBS company. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. Good health habits can also help prevent and fight COVID-19. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? See the Allowed Virtual Services document located on anthem.com/For Providers/Provider Resources/Forms & Guides/Select a State/Allowed Virtual Services (Telehealth/Telemedicine) for allowable codes for telehealth visitsfor physical, occupational and speech therapies for visits coded with place of service (POS) 02 and modifier 95 or GT for our fully-insured employer, individual, Individual, Medicare Advantage plans and Medicaid plans, where permissible. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. In Kentucky: Anthem Health Plans of Kentucky, Inc. cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. 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. Prior authorization is not required for COVID-19 testing. Oct 13, 2022 While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. Anthem is committed to working with and supporting our contracted providers. Are there any in-network or out-of-network limitations on these guidelines? For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. 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 Centers for Disease Control and Prevention: About 2019 Novel Coronavirus (2019-nCoV) (January 28, 2020): How can I find a COVID-19 testing location? Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Findings. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. 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. Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. They include fever, cough, and shortness of breath. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Anthem is relaxing early prescription refill limits, where permitted, for members who have Anthem pharmacy benefits and wish to refill a 30-day supply of most maintenance medications early. Out-of-network coverage will be provided where required by law. 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 . Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Please note this coverage does not apply to LiveHealth Online visits. Log in to anthem.com, go to Claims & Payment, and choose Submit a Claim. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. 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). COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing Anthem is a registered trademark of Anthem Insurance Companies, Inc. Please log in and update your communication preferences to make sure you receive the latest information. For fully-insured commercial health plans issued in Colorado, Anthem will cover diagnostic lab tests for flu, respiratory syncytial virus (RSV), and others as required by law when determining the need for COVID-19 testing. The electronic process is the quickest way to get the claims to Anthem. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. 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. To access your member services, please visit your BCBS company. 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. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. Some Anthem health plans include LiveHealth Online. The CDC has provided coding guidelines related to COVID-19: Error! And if you use a pharmacy in Prime's network and check out at the pharmacy counter, you shouldn't have to pay upfront or submit a claim for reimbursement. Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. div.treatment-testing-cont div.motif-icon.motif-syringe:before, Call 911 if you see emergency warning signs like the below. Cost shares will be waived for in-network providers only. Treatment that's safe and convenient Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. Does Anthem require use of a contracted provider for the COVID-19 lab test in order for waiver of the members cost share to apply? ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. Kaiser found: 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue Shield of California, Care First, Cigna, CVS Group/Aetna, and Kaiser Permanente) are currently relying only on . Log in to find out whether youre eligible to order an at-home test kit from Anthem. Symptoms may appear 2-14 days after being around someone who has COVID-19. From March 19, 2020, through January 11, 2023, Anthem will cover and waive cost shares for telephonic-only visits with in-network providers for our Medicare Advantage plans. A Guide to Improving the Patient Experience, A Guide to Screening, Brief Intervention, and Referral to Treatment, Early and Periodic Screening, Diagnostic and Treatment, COVID-19 vaccines for youth toolkit available, Monoclonal Antibodies Approved for Treatment of COVID-19 Infection (June 7, 2021), New COVID-19 Vaccine Codes and Vaccine Administration Codes, Medicaid Services Manual Chapter 400 Updated (April 29, 2021), Attention All Providers Performing COVID-19 Diagnostic Testing with Procedure Code 87426 (April 28, 2021), Maximizing efficient, high quality COVID-19 screenings (April 4, 2021), Encounter-Based Providers and COVID-19 Vaccine Billing (March 8, 2021), DHCFP COVID-19 covered services, vaccines, and vaccination prioritization lanes information for members (February 18, 2021), Rate Change for COVID-19 Testing Codes U0003 and U0004 (February 18, 2021), Attention Providers Who Wish to Enroll with Nevada Medicaid to Administer the COVID-19 Vaccine (January 5, 2020), COVID-19 Vaccine Administration Coverage and Billing (January 5, 2020). Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. Providers should continue to verify eligibility and benefits for all members prior to rendering services. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. 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). Use Psych Hub's resources to help you manage and cope in stressful times. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines. 2023 Blue Cross Blue Shield Association. How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes. %%EOF Reimbursement for over-the-counter tests. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. If you have questions or would like help finding testing, please call the Member Services number on your ID card. Plus, we will keep you updated as things develop. 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. COVID-19 vaccines for youth toolkit available. 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. Anthem members also can call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse about health questions. If your doctor recommended you get tested, find a nearby COVID-19 testing site. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. For COVID-19 treatments via telehealth visits, Anthems affiliated health plans will cover telehealth and telephonic-only visits from in-network providers and will waive cost shares through January 31, 2021. At-home test kits from Anthem: Are FDA-authorized. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. 24/7 access is provided at no cost. It lets you see a doctor through live chat or video on your phone, tablet, or computer. Need coverage now due to job loss? Members will pay no deductible, copay or coinsurance for services ranging from doctors visits to hospital stays when their testing or treatment is related to COVID-19. Anthem covers COVID-19 diagnostic tests for all members with no out-of-pocket costs. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. Anthems fully-insured commercial plans issued in Colorado cover telehealth as required by applicable law. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. 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. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. We are fielding questions about the outbreak from our customers, members, providers and associates. If their symptoms get worse, call their doctor. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. Many thousands of people across the United States took part in research trials over many months. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. In Maine: Anthem Health Plans of Maine, Inc. No copays for telehealth services provided by Teladoc. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) div.treatment-testing-cont div.motif-icon.motif-marker:before { Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment Cost sharing will be waived for members using Anthems authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. 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. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. Hyperlink reference not valid. 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. Please review the Medicare and Medicaid specific sites noted below for details about these plans. 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. At-home test kits are available to eligible Anthem members for a limited time. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. Similar to a cold or the flu. endstream endobj startxref Anthem is a registered trademark. Effective May 1, 2021, for members of our fully-insured employer and individual plans, as well as self-funded plans, Anthem will reimburse for the administration of COVID-19 FDA-approved vaccines at a rate of $40 per administration. Where permissible, these guidelines apply to FEP members. CMS has provided the Medicare guideline to use the CS modifier: Error! COVID-19 testing remains an important part of keeping our families and communities safe. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. At-home diagnostic tests can be purchased over the counter online, at a local pharmacy, or from a big-box store. Waiving all prior authorization requirements for COVID-19 testing and related covered services. 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. hbbd```b``:"@&@$2X&9 `2H2?bo X 2X* 0 * }X Future updates regarding COVID-19 will appear in the monthly Provider News publication. Effective April 3, 2020, and for the duration of and consistent with Colorados emergency orders, Anthem will cover the additional services outlined in those orders. Anthem.Com/Ca to use the CS modifier: Error requirements for COVID-19 testing and visits related COVID-19! Check the CDC, vaccination prevents severe illness, hospitalizations, and.... ( CDC ) is closely monitoring the COVID-19 outbreak are no delivery charges for members who use Anthems Sydney mobile... Should be tested for COVID-19, our benefit changes, financial assistance and more doctor or hospital that your..., find a nearby COVID-19 testing services on or after January 15, 2022 applicable for employer-sponsored. And update your communication preferences, tablet, or from a big-box store see a doctor from home screen! Phone, tablet, or touching any mobility devices or equipment to for! & amp ; payment, and choose Submit a Claim out-of-network limitations on these guidelines apply to Online! 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