How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Get Reimbursed for Over-the-Counter COVID-19 Tests. *Applies only for members with Anthem pharmacy benefits. Oct 13, 2022 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. Waiving cost-sharing for COVID-19 testing and treatment. font-size: 50px;
7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. 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 . For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. California Department of Public Health COVID-19 Updates, State of California Coronavirus (COVID-19) Response, (CDC) - People at Risk for Serious Illness from COVID-19, U.S. Department of State, Travel Advisories, World Health Organization (WHO), Coronavirus, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), vaccination prevents severe illness, hospitalizations, and death, cdc.gov/coronavirus/2019-ncov/about/index.html. %%EOF
If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. To access your member services, please visit your BCBS company. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Anthem does not cover telephonic-only services today (with limited state exceptions) but we are providing this coverage effective from March 19, 2020, through January 11, 2023, to reflect the concerns we have heard from providers about the need to support continuity of care for Plan members during extended periods of social distancing. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. Reimbursement for over-the-counter tests. 132 0 obj
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If your doctor isnt available for some reason, well help you find alternate care. Anthem members have access to telehealth 24/7 through LiveHealth Online. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. What you need to know about the disease and our coverage commitment. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. 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. A few things to know: Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is coveredunder certain conditions. . Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. COVID-19 vaccines for youth toolkit available. Call our 24/7 Nurse Line for COVID-related health questions and advice. Some Anthem health plans include LiveHealth Online. Screening tests show whether or not someone has COVID-19. Member Discounts Take advantage of member-only discounts on health-related products and services. Please be advised that, while awaiting further guidance from the Department of Managed Health Care (DMHC)/ Department of Health Care Services (DHCS) regarding SB510, Anthem Blue Cross will pay Medi-Cal claims for COVID-19 testing incurred on or after January 1, 2022, according . 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. 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. Participating hospitals without lab fee schedules will follow the same lab testing reimbursement as defined in their facility agreement with Anthem inclusive of member cost share amounts waived by Anthem. border-radius: 50%;
The 90-day waiver of cost-shares for telehealth visits unrelated to COVID-19 (such as general medical and behavioral health care) applies to in and out of network providers. endstream
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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 you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. To learn where you can obtain a test visit the State of New Jerseys. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Is Anthems vendor, LiveHealth Online, prepared for the number of visits that will increase to telehealth? Plus, we will keep you updated as things develop. Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Taking care of your emotional health is important during this stressful time. Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Log in to find out whether youre eligible to order an at-home test kit from Anthem. 111 0 obj
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Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Eligible members can find an in-network doctorhereor access HorizonCareOnline through the Horizon Blue app,www.horizoncareonline.com, orwww.HorizonBlue.com. It lets you see a doctor through live chat or video on your phone, tablet, or computer. Yes, we will cover COVID-19 home testing kits that are available over the counter. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. 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. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. 24/7 access is provided at no cost. 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. Please log in and update your communication preferences to make sure you receive the latest information. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. 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. Find free and reduced-cost support for food, transportation, housing, health and more. Visit the CDC website for the most up-to-date testing guidance. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. At-home diagnostic tests can be purchased over the counter online, at a local pharmacy, or from a big-box store. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. Many plans include telephone care benefits during this public health emergency. 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. Anthem will waive member cost shares for COVID-19 lab tests performed by participating and non-participating providers. 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). Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. You may also receive a bill for any charges not covered by your health plan. If you have questions or would like help finding testing, please call the Member Services number on your ID card. The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. What codes would be appropriate to consider for telehealth (audio and video) for physical, occupational, and speech therapies? margin-bottom: 40px;
Out-of-network coverage will be provided where required by law. According to the CDC, vaccination prevents severe illness, hospitalizations, and death. Anthem is committed to making sure you can get the care you need. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) If your doctor recommended you get tested, find a nearby COVID-19 testing site. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? 155 0 obj
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No. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Call the National Information Center weekdays from 8 a.m. to 8 p.m. For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. 2023 Blue Cross Blue Shield Association. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Its part of the same family of coronaviruses that includes the common cold. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. Wash your hands or use hand sanitizer when entering their house or room. In Connecticut: Anthem Health Plans, Inc. 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. Centers for Disease Control and Prevention: About 2019 Novel Coronavirus (2019-nCoV) (January 28, 2020):
If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. 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. Johns Hopkins University has resources to help you learn more about the disease. background-color: #7fcdbb;
Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. Clean surfaces often, like countertops, doorknobs, light switches, faucets and more. In Maine: Anthem Health Plans of Maine, Inc. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. If youre in the same room, car or doctors office with someone who is sick, both of you should cover your nose, mouth and chin with a. Save your receipts when you purchase over-the-counter COVID-19 diagnostic tests. COVID-19 screening related tests (e.g., influenza tests, blood tests, etc.) 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. 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). This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. 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. Please check the CDC for the most up-to-date list of symptoms. 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. Wash your hands and use hand sanitizer before and after touching someone or any mobility devices (canes, a walker) or other equipment. On December 18, 2020, the FDA also approved the Moderna vaccine for EUA for individuals aged 18 years and older. Where permissible, these guidelines apply to FEP members. Leading the way in health insurance since 1929. The guidance here can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)-contracted laboratories and identify the proper CPT codes to use. }. Providers who currently submit electronic claims are encouraged to do so. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. cost sharing for telehealth in-network visits for COVID-19 treatment from March 17, 2020, through January 31, 2021, including visits for behavioral health, for our fully-insured employer, individual plans, and where permissible, Medicaid. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. }
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