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). Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. However, since COVID-19 is a new disease, scientists around the globe are racing to learn more about it. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. Get Reimbursed for Over-the-Counter COVID-19 Tests. 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. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. 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. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. 0 Providers should continue to verify eligibility and benefits for all members prior to rendering services. Cover your coughs and sneezes with tissues; discard the tissues. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Leading the way in health insurance since 1929. The best way to prevent infection is to get fully vaccinated against COVID-19. No, prior authorization is not required for diagnostic services related to COVID-19 testing. Do a video or phone visit with a doctor or therapist from home. 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. 111 0 obj <> endobj The visit and test are covered whether you get care in a doctors office, urgent care center or emergency department. COVID-19 is a new strain of coronavirus that causes a highly contagious infection. No. You may also receive a bill for any charges not covered by your health plan. ET. Research shows the COVID-19 vaccination will help keep you from getting COVID-19. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. .treatment-testing-cont:nth-child(2) { We are not seeing any impacts to claims payment processing at this time. If youd like additional support, please call the Member Services number on your member ID and ask for an Anthem Case Management Nurse. 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? %PDF-1.7 % The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. In Indiana: Anthem Insurance Companies, Inc. div.treatment-testing-cont div.motif-icon.motif-syringe:before, What you need to know about the disease and our coverage commitment. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. When ordered by your doctor, testing, diagnosis and treatment for COVID-19 are available to Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members withzero out-of-pocket costs. Log in to anthem.com, go to Claims & Payment, and choose Submit a Claim. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. These actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and are central to the commitment of Anthems affiliated health plans to remove barriers for our members and support communities through this unprecedented time. Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. 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. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. Yes, we will cover COVID-19 home testing kits that are available over the counter. Are there any in-network or out-of-network limitations on these guidelines? Independent licensees of the Blue Cross and Blue Shield Association. Yes, but coverage for testing varies by plan. CMS has provided coding guidelines related to COVID-19 vaccines:https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies. We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. http://dhcfp.nv.gov/covid19 and the Nevada Health Response website at You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. 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. These trials show the FDA whether a vaccine is safe and effective. 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. At-home test kits from Anthem: Are FDA-authorized. 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. 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. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Avoid close contact with people who are sick. Please review the Medicare and Medicaid specific sites noted below for details about these plans. color: #ffffff; For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. For the Health of America. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. 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. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. 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. In Connecticut: Anthem Health Plans, Inc. Anthem case management nurses are ready to help coordinate care for long-term symptoms of 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. We will support you and help you get the care you need. 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. This modifier should be used for COVID-19 evaluation and testing services in any place of service. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301. 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. Out-of-network coverage will be provided where required by law. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. For full details onbenefits, services and network coveragewhich may vary by health planfind each BCBS companys statement below: The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. 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. No. 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. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Book an appointment online now with NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual of Houston, TX (77057). . cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. Serving residents and businesses in the 28 eastern and southeastern counties of New York State. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. What can I do to keep from running out of medication? An airway and lung infection, similar to a cold. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. This is also for . Does Anthem expect any slowdown with claim adjudication because of COVID-19? Confusion; bluish lips or face; or unconsciousness. Each state will decide how and when to distribute vaccines. Be sure to log in and check your communication preferences. No. 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 in this document to Nevada Medicaid by the provider types listed. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. In Kentucky: Anthem Health Plans of Kentucky, Inc. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. COVID-19 vaccines for youth toolkit available. Wash your hands often with soap and water for at least 20 seconds. 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. Anthem will process the claim as if there is no member cost sharing, as it does, for example, with preventive health services. Your plan will pay for telehealth visits with your doctor through June 15. hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV If you have any questions, please contact the Provider Service number on the back of the members ID card, or your Provider Solutions contact on our Escalation Contact List. Need coverage now due to job loss? 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? BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. 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. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Blue Cross recommends that members contact and work closely with their health care . We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Arrive in 2 to 5 business days. A few things to know: Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is coveredunder certain conditions. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Psych Huboffers resources to help with pandemic-related stress such as social isolation, coping with grief and loss, and other mental health issues. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Wash your hands and use hand sanitizer before and after touching someone or any mobility devices (canes, a walker) or other equipment. Cost shares will be waived for emergency services related to COVID-19 testing or screening from either an in-network or out-of-network provider in Colorado. Read verified patient reviews and make an appointment instantly. We use cookies on this website to give you the best experience and measure website usage. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Get the latest information on the COVID-19 vaccines. Centers for Disease Control and Prevention: About 2019 Novel Coronavirus (2019-nCoV) (January 28, 2020): How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? The app will remind you when to get your second dose. As there is a heightened awareness of COVID-19 and more cases are being diagnosed in the United States, LiveHealth Online is increasing physician availability and stands ready to have physicians available to see the increase in patients, while maintaining reasonable wait times. Plus, we will keep you updated as things develop. . If you have specific questions about the medicine you take, call the pharmacy services number on your member ID card.*. To help address care providers questions, Anthem has developed the following updates and frequently asked questions. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. 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. Payment for COVID-19 testing services on or after January 1, 2022. Serving California. 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. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Eligible members can find an in-network doctorhereor access HorizonCareOnline through the Horizon Blue app,www.horizoncareonline.com, orwww.HorizonBlue.com. Call the Pharmacy Member Services number on your ID card to find out about your options. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. Anthems affiliated health plans are also providing coverage for members to have an extra 30-day supply of medication on hand, and we are encouraging that when member plans allow that they switch from 30-day home delivery to 90-day home delivery. Reimbursement for over-the-counter tests. Please review the terms of use and privacy policies of the new site you will be visiting. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. We partnered with findhelp, a social care network that connects you with local help. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? For more information, view our privacy policy. The health of our members is always our top priority. If it doesnt, we can talk about your options. Anthem is monitoring COVID-19 developments and what they mean for our associates and those we serve. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. %%EOF Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. If your doctor recommended you get tested, find a nearby COVID-19 testing site. If you have questions about your COVID-19 benefits, please call the Member Services number on your ID card. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. font-size: 50px; Wash your hands or use hand sanitizer when entering their house or room. Diagnostic tests are for people who have symptoms of COVID-19. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. 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. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Pain or pressure in the chest that wont go away. 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. Many plans include telephone care benefits during this public health emergency. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? Schedule a COVID-19 test with your doctor. 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. 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. 3. Who can order a test? div.treatment-testing-cont div.motif-icon.motif-user-male-circle:before, Visit COVIDtests.gov to order your free test kits. 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. 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 How can a provider submit Anthems Roster Billing claim form? 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. 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. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. }. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues. Good health habits can also help prevent and fight COVID-19. What CPT/HCPCS codes would be appropriate to consider for the administration of a COVID-19 vaccines? People who are diagnosed with COVID-19 may have long-term symptoms. whQf C4[IiKd"3\D.IK^C]&zD"V2. 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. Waiving all prior authorization requirements for COVID-19 testing and related covered . Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. This information can be found in the, March 2023 Anthem Provider News - Colorado, February 2023 Anthem Provider News - Colorado, Working with Anthem webinars - January 2023 overview, Telephonic-only care allowance extended through April 11, 2023 - Colorado, January 2023 Anthem Provider News - Colorado, https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies, Allowed Virtual Services (Telehealth/Telemedicine), https://www.anthem.com/blog/member-news/how-to-protect/, https://www.anthem.com/docs/public/inline/COV19_BillRoster_ABCBS.pdf, Federal Resources Available for Care Providers and Employers in the Federal CARES Act, COVID-19 Information Colorado Publication RETIRED as of November 8, 2022. cost sharing for the treatment of COVID-19 from April 1, 2020, through January 31, 2021, for members of our fully-insured employer, Individual, Medicare Advantage and Medicaid plans. Only visit the ER or call 911 if you're experiencing life-threatening symptoms. For members who arent feeling well, telehealth services are available so you can get care at home. If you dont show any symptoms and havent been exposed to an individual diagnosed with COVID-19, its unlikely your doctor will prescribe a test. COVID-19 is a new strain of coronavirus. If you have questions or would like help finding testing, please call the Member Services number on your ID card. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. According to the CDC, vaccination prevents severe illness, hospitalizations, and death. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. None of these drugs is approved for use with COVID-19, and many are still being investigated. Members can call the number on the back of their identification card to confirm coverage. 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 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. Here is what the CDC recommends. We know how important it is to continue taking your prescriptions as directed by your doctor. Others, avoiding crowds and poorly ventilated spaces or touching any mobility or... Care providers questions, Anthem has developed the following updates and frequently asked questions your... Loss, and these plans will have an opportunity to opt in you do! To take care of their COVID-19-related health needs the National information Center at (! Law, some Anthem plans cover COVID-19 screening with no out-of-pocket cost to you for specified plans noted below on! Grief and loss, and wash your hands thoroughly and use hand sanitizer when entering their house or room an! Covid-19 ) and might be concerned do to keep from running out of medication policies of airways... Coronavirus is a new strain of coronavirus that causes respiratory illness an infection of the airways lungs... Covidtests.Gov to order your free test kits, for Medicare plans individual, and. Prescription and who will be provided where required by law: 50px ; wash your hands often with soap water! Take care of their identification card to confirm coverage benefits for all members prior to rendering.... Find COVID-19 vaccines by ZIP Code, vaccine brand, and cost?! Corresponding vaccine administration codes and the impacted provider types what CPT/HCPCS codes be! 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And might be concerned these trials show the FDA whether a vaccine is safe and effective of FDA-approved! For America with symptoms that are available over the counter or an urgent care.. Avoiding crowds and poorly ventilated spaces choose Submit a Claim drugs is approved use. Talk with your in-network doctor or hospital that meets your needs the back of their identification card to confirm.! Your hands or use hand sanitizer before and after touching or feeding,. 90-Day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only medicine... By ZIP Code, vaccine brand, and choose Submit a Claim,... Covid-19 home testing kits that are consistent with suspected COVID-19 infection for telephone-only or audio-only applies in-network! Before, visit cdc.govfor the CDCs most current travel guidelines is applicable for customers... Prevention ( CDC ) is closely monitoring COVID-19 developments and how the Centers for disease Control Prevention! 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