711. Plus, you may qualify for financial help to lower your health coverage costs. Understand your care options ahead of time so you can save time and money. Call Pharmacy Member Services toll free at 1-833-370-7466 (TTY: 711) 24 hours a day, 7 days a week to ask us to mail you a Drug List. Or Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. Your browser is not supported. Southfield, MI 48075, 1-877-293-2788 To report fraud, waste or abuse, call our hotline: 1-800-437-3803 Members dont receive multiple letters focused on individual clinical and cost-of-care programs. Vision and hearing providers: 1-800-482-4047 Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: Our resources vary by state. Blue Cross Blue Shield of Michigan Compare plans available in your area and apply today. 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. 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). If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. We offer flexible group insurance plans for any size business. Step 5: Tell the system the date of service. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Find out if your medication is available through CVS Specialty. L07B For help with AcariaHealth, call 1-800-511-5144 (TTY 1-800-955-8770), Monday through Friday, 8:00 a.m. to 10:00 p.m., Eastern time. Box 7355 Monday through Friday. Monday through Friday, 1-800-431-1059 You can also visit. Monday through Friday You can count on our guidance, education, and compassion throughout your entire course of treatment. This applies to members with Preferred Provider Organization (PPO), HealthKeepers (HMO), POS AdvantageOne, and Act Wise (CDH plans). Get access to your online account. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. If you call before 30 days, we may not be able to check your claim through our automated phone system. 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. Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. A specialty pharmacy does more than just fill prescriptions. Detroit, MI 48232-0593, UB-04 claims These pharmacies serve members with complex or chronic conditions. Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. Health equity means that everyone has the chance to be their healthiest. Refill and track your specialty drug prescriptions, pay online, and get live support. View our map (PDF). Well take it from there. CarelonRx is the pharmacy benefits manager (PBM) for Anthem HealthKeepers Plus members in Virginia. The purpose of this communication is the solicitation of insurance. For costs and complete details of the coverage, please contact your agent or the health plan. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. This applies to all specialty drugs covered through the Medicaid health maintenance organization (HMO) members medical benefits where Anthem has financial risk for the cost of specialty medications. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. 8:30 a.m. to noon and 1 to 5 p.m. The resources for our providers may differ between states. Check ereferrals.bcbsm.com for detailed prior authorization information. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. 1 0 obj Monday through Friday. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. You can count on our guidance, education, and compassion throughout your entire course of treatment. You can also talk to your provider consultant. It can also send you a copy of your claim's status. The resources for our providers may differ between states. Independent licensees of the Blue Cross and Blue Shield Association. We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. If your state isn't listed, check out bcbs.com to find coverage in your area. London, KY 40742. TTY users: To reach any number listed here, dial 711. 1-877-258-0167 Providing care for those who need it most requires a team effort. PO Box 385018 <> Not sure which region you're in? Not connected with or endorsed by the U.S. Government or the federal Medicare program. Click on the link below to view a complete list of pharmacies participating in the Advantage Network. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. Box 33248 Search for specific text by using your Find function (Ctrl+F or Command+F). We send members personalized messages about medications that may reduce their costs and include specific cost savings. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Blue Care Network 1-888-826-8152 Anthem ( NYSE: ANTM ) is one of the largest managed care organizations in the United States. Large Group Monday through Friday 8 a.m. to 7 p.m. Essential Vision providerssubmit claims throughHeritage Vision Plan. Box 68753 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. Members have one vendor, one contact, and one ID card. 8 a.m. to 7 p.m. 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. Birmingham, AL 35238-0518. Some drugs, and certain quantities of some drugs, require an approval before they are eligible for coverage. New member? <>>> 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 look forward to working with you to provide quality service for our members. Step 4: Say "no" when asked if you have additional questions about the determination of a claim. 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. Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. The resources on this page are specific to your state. AINPEC-2262-19 October 2019 Specialty Drug List Grand Rapids, MI 49523-0589, Provider Inquiry Blue Care Network Featured In: Contact customer service, Heritage Provider service: 1-800-252-2053. 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. Get access to your agent portal.Register Now. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. 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. We currently don't offer resources in your area, but you can select an option below to see information for that state. Our medical and pharmacy experts work collaboratively. We also offer infusion services with Optum Infusion Pharmacy. View our map (PDF). x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ 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. Southfield, MI 48075. Whether you need to check on a claim, pay a bill, or talk to a representative, you can easily access all your member features. Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. Register Now, Not registered? 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. Just keep in mind you'll need to go through the prompts before you're connected to someone. We use Availity Essentials as our provider portal. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. You can also visit. View listings below of the retail pharmacies that participate in our pharmacy networks. Pay outstanding doctor bills and track online or in-person payments. Taking time for routine mammograms is an important part of staying healthy. A specialty pharmacy does more than just fill prescriptions. Facility and Special Programs CVS Specialty helps patients with complex conditions manage their medications and live their best lives. Note:It can take up to 30 days for a claim to be processed. Get access to your online account.Register Now, Not registered? Preferred Drug List and Formulary Search 8:30 a.m. to noon and 1 to 5 p.m. Providing care for those who need it most requires a team effort. Provider Inquiry Mail Code 0301 42I]?evMJz8q9|eszwdZL9}owq1}s&,/K{IP,xW^.` 8:30 a.m. to noon and 1 to 5 p.m. 8 a.m. to 4 p.m. Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Make your mental health a priority. We currently don't offer resources in your area, but you can select an option below to see information for that state. Blue Vision providers submit claims electronically directly toVSP. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. 1-844-396-2329 (TTY 711). Say "another contract" to inquire on another contract. You can find yours by selecting your region: Not sure which region you're in? 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. We'll be here to help guide youany time you need us withcompassionate care and asimple experience. Get access to your agent portal. P.O. 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. % For the Rx Choice and Base Networks, you can also find Retail 90 and Rx Maintenance 90 pharmacies where you can obtain up to a 90-day supply of your medicine, including CVS. This applies to all Anthem Indiana commercial members. The Rx Choice Tiered Network may not be available in all states. If a medication is selected that is not on the drug list, the member will be responsible for the full cost of the drug. Available for iOS and Android devices. 8 a.m. to 5 p.m. Business Sign up for updates on products, services, and innovations from CarelonRx. P.O. We also offer infusion services with Optum Infusion Pharmacy. IngenioRx is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. 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