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. If you have questions or would like help finding testing, please call the Member Services number on your ID card. What financial assistance is available for care providers during the COVID-19 crisis? Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. 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 . Anthem members will receive the COVID-19 vaccination at no cost, Anthem will help you coordinate COVID-19 care, Anthems alternative virtual care offerings, Prescription Medications and Pharmacy Services, Take advantage of emotional and mental health support. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. %%EOF Increasing access to prescription medications. Hyperlink reference not valid.. Anthem also looks for the CS modifier to identify claims related to evaluation for COVID-19 testing. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Mild to severe fever, cough and shortness of breath. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. 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. In Ohio: Community Insurance Company. Download the Sydney Health app. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. 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. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. whQf C4[IiKd"3\D.IK^C]&zD"V2. 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. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. padding: 0.6rem; Reimbursement for over-the-counter tests. Anthem is monitoring COVID-19 developments and what they mean for our associates and those we serve. At-home test kits from Anthem: Are FDA-authorized. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Out-of-network coverage will be provided where required by law. 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. Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . 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. Read verified patient reviews and make an appointment instantly. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. *Applies only for members with Anthem pharmacy benefits. You may also receive a bill for any charges not covered by your health plan. Steps you can take to protect yourself and others from COVID-19: Its best to follow the CDCs recommendations for using a facemask. Reimbursement is available only during the COVID-19 public health emergency. We have made changes to how behavioral health providers can use and be compensated for telehealth (audio + video) and telephonic-only care with their patients. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. If you are, youll be able to place an order. Check your COVID-19 benefits by using the Sydney Health or Engage Wellbeing mobile app, logging into anthem.com/ca, or calling the Member Services number on your ID card. If youd like additional support, please call the Member Services number on your member ID and ask for an Anthem Case Management Nurse. 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. 111 0 obj <> endobj No. Member Discounts Take advantage of member-only discounts on health-related products and services. Thats why we are committed to ensuring our members who are dealing with a diagnosis of COVID-19 can easily access the care they need.. If you are not, please use our Test Site Finder to learn about options near you. Administrative. 0 Anthems enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthems Virtual Command Center for Emergency Management command, control and communication. 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. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. Schedule a COVID-19 test with your doctor. If your doctor offers telehealth visits, your plan will pay for those, too. 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. The app will remind you when to get your second dose. Focusing solely on testing symptomatic patients may not be sufficient to prevent further transmission of COVID-19. For non-COVID-19 tests (like flu, RSV, etc.) A diagnostic test is used to determine if a person has COVID-19. Are COVID-19 tests covered? 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. Other self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and we will continue to work with them to administer their plan designs as directed. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Visit COVIDtests.gov to order your free test kits. Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. . Ordering at-home test kits from Anthem. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. Research shows the COVID-19 vaccination will help keep you from getting COVID-19. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. Go to the main page on anthem.com/ca to log in and search for a doctor, or call the Member Services number on your ID card. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. No. 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? You should try to see your PCP or a doctor in your plan. Update your email address and choose the email option under Helpful Information to stay informed on COVID-19. COVID-19 testing remains an important part of keeping our families and communities safe. Will Anthem allow Roster Billing for the COVID-19 vaccine? The CDC has provided coding guidelines related to COVID-19: Error! 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. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. 2023 Blue Cross Blue Shield Association. However, since COVID-19 is a new disease, scientists around the globe are racing to learn more about it. In addition, Anthem has established a team of experts to monitor, assess and help facilitate timely mitigation and response where we have influence as appropriate for the evolving novel coronavirus threat. If youre caring for someone, be sure visitors take care to avoid causing any extra risk to you or them keep hand sanitizer by the door, or ask visitors to wash their hands. No cost share for diagnostic tests or treatment. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. Check out our frequently asked questions about COVID-19, our benefit changes, financial assistance and more. 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. 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? Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. 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. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. www.cdc.gov/coronavirus. Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. Are there any prescription drugs that can be used to treat COVID-19? If you have a Medicaid plan with us, you do not have to pay anything for the COVID-19 test or the doctor visit to get the test. Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. 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 it doesnt, we can talk about your options. Check the. What codes would be appropriate to consider for a telehealth visit with a patient who wants to receive health guidance during the COVID-19 crisis? How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Dont stop taking your medicines as prescribed, and get your refills on time. The best way to prevent infection is to avoid being exposed to the virus. Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. The cost-sharing waiver includes copays, coinsurance and deductibles. Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. Members can call the number on the back of their identification card to confirm coverage. Use of the Anthem websites constitutes your agreement with our Terms of Use. In Connecticut: Anthem Health Plans, Inc. Leading the way in health insurance since 1929. This applies to both diagnostic and screening tests. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? 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Springfield Named President of Blue Cross and Blue Shield of Texas. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. This modifier should be used for evaluation and testing services in any place of service including a physicians office, urgent care, ER or even drive-thru testing once available. Cant reach your doctor? Anthem recognizes the intense demands facing doctors, hospitals and all health care providers in the face of the COVID-19 pandemic. 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 . We know how important it is to continue taking your prescriptions as directed by your doctor. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? 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