What codes would be appropriate to consider for telehealth (audio and video) for physical, occupational, and speech therapies? Wash your hands and use hand sanitizer before and after touching someone or any mobility devices (canes, a walker) or other equipment. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. How can a provider submit Anthems Roster Billing claim form? Please discuss additional questions about COVID-19 treatments and medicines with your doctor. Screening tests show whether or not someone has COVID-19. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. Call our 24/7 Nurse Line for COVID-related health questions and advice. Need coverage now due to job loss? We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. 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. 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. 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. Anthem will waive cost-sharing requirements for testing and the cost of the testing, and for emergency services related to COVID-19 screening or testing from any provider. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. 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. 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. If their symptoms get worse, call their doctor. Here are some tips: Older adults, people with disabilities, and people with diabetes orwho have severe chronic medical conditions like heart, lung or kidney disease seem to be at higher risk for more serious COVID-19 illness. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. Its part of the same family of coronaviruses that includes the common cold. 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). Providers may submit the COVID-19 Vaccination Roster Billing Form to Availity at https://www.availity.com/ by signing in and submitting the form electronically to the Anthem health plan. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. We know how important it is to continue taking your prescriptions as directed by your doctor. If your doctor offers telehealth visits, your plan will pay for those, too. 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. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. If youre experiencing symptoms or if your doctor recommends a test, use our COVID-19 Test Site Finder to search your ZIP Code and find testing options near you. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. 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. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. What is changing regarding prior authorization requirements? Call 911 if you see emergency warning signs like the below. What financial assistance is available for care providers during the COVID-19 crisis? The best way to prevent infection is to avoid being exposed to the virus. Does Anthem expect any slowdown with claim adjudication because of COVID-19? 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. We'll also explore the additional care and support available for your protection and everyday needs. At-home test kits are available to eligible Anthem members for a limited time. This applies to both diagnostic and screening tests. 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. Research shows the COVID-19 vaccination will help keep you from getting COVID-19. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. To help address care providers questions, Anthem has developed the following updates and frequently asked questions. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. Get the latest information on the COVID-19 vaccines. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. Reimbursement is available only during the COVID-19 public health emergency. 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. 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. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? 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. These products are restricted from coverage through the pharmacy point-of-sale (POS) system. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? 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. 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. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. 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. Many thousands of people across the United States took part in research trials over many months. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Good health habits can also help prevent and fight COVID-19. Your member ID card is your key to using your medical plan benefits. div.treatment-testing-cont div.motif-icon.motif-marker:before { 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. To ensure you have access to the right care at the right time, FEP is waiving cost shares and prior authorization to support members care for COVID-19. However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. Please check the CDC for the most up-to-date list of symptoms. Each state will decide how and when to distribute vaccines. To access your member services, please visit your BCBS company. 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. Anthem is a registered trademark of Anthem Insurance Companies, Inc. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. People at most risk of contracting COVID-19 or developing complications of illness are scheduled to receive vaccinations first. 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. They include fever, cough, and shortness of breath. COVID-19 screening related tests (e.g., influenza tests, blood tests, etc.) 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. Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. Hydroxychloroquine and chloroquine will be covered only for FDA-approved indications: Visit the Division of Health Care Financing and Policy website at 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. The cost-sharing waiver includes copays, coinsurance and deductibles. For members who arent feeling well, telehealth services are available so you can get care at home. We know these are challenging times, and want you to know that we remain deeply committed to supporting you to get care and protect your overall health and wellbeing. Anthem members will receive the COVID-19 vaccination at no cost Coverage for COVID-19 testing COVID-19 treatment Visit a doctor from home Refill your prescription medication early Emotional and mental health support resources are available Sources The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. This applies to all members, regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for COVID-19 vaccination. How does my plan cover the over-the-counter test? 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. Plus, we will keep you updated as things develop. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? Are there any prescription drugs that can be used to treat COVID-19? We are not seeing any impacts to claims payment processing at this time. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention (CDC) to help us determine what action is necessary on our part. Member Discounts Take advantage of member-only discounts on health-related products and services. What can I do to keep from running out of medication? Administrative. Every day, use household cleaner to wipe the surfaces of frequently-used equipment or devices. 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. You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. Check the. 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. Member Discounts Take advantage of member-only discounts on health-related products and services. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. cost sharing for visits where the purpose of the visit is to be screened and/or tested for COVID-19, regardless of whether test is administered, beginning March 18, 2020, for members of our employer-sponsored, individual, Medicare and Medicaid plans. margin-bottom: 40px; It also lets you notify the CDC of any side effects you may experience. 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? The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. No cost share for diagnostic tests or treatment. 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