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In Kentucky: Anthem Health Plans of Kentucky, Inc. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). These manuals are your source for important information about our policies and procedures. External link You are leaving this website/app (site). Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Some procedures may also receive instant approval. Pharmacy Forms. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. You'll also find news and updates for all lines of business. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. Anthem does not require prior authorization for treatment of emergency medical conditions. Home Employer Federal Employees Blue Cross And Blue Shield Service Benefit Plans Medical Plans Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. Availity Portal for behavioral health authorizations, or contactProviderServices for assistance. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. 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. These documents contain information about upcoming code edits. You can also refer to the provider manual for information about services that require prior authorization. hb``` ce`a`Y5 bR;)/}ksN}J^dcZ9@ @Hw400P`a Pl fKU0 e`c cpIqc1$frf3Hf6S\k{3*0ue`dzAyF ~ H00#9 L ICR in Availityfor all notifications or prior authorization requests, including reporting a members pregnancy. In Ohio: Community Insurance Company. Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Please note: This change is not applicable to the members enrolled in the Mercy Co-worker Plan as they have a customized prior authorization list. PPO outpatient services do not require Pre-Service Review. Call our Customer Service number, (TTY: 711). ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. Effective 01/01/2023 (includes changes effective 04/01/2023) . For your convenience, we've put these commonly used documents together in one place. Information to help you maximize your performance in our quality programs. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. To get started, select the state you live in. Availity, LLC is an independent company providing administrative support services on behalf of HealthKeepers, Inc. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Select Auth/Referral Inquiry or Authorizations. Forms and information to help you request prior authorization or file an appeal. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. %PDF-1.6 % ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This step will help you determine if prior authorization may be required for a specific member and service. Anthem offers great healthcare options for federal employees and their families. An Anthem (Blue Cross Blue Shield) prior authorization form is what physicians will use when requesting payment for a patient's prescription cost. Plans for federal employees, retirees, retired uniformed service members, and active duty family members. Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. Sign up to receive personalized communication from us, and we'll refine it to meet your preferences. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Medicare Coverage with Anthem Medicare Information Medicare Coverage and Enrollment Turning 65 Medicare Advantage Plans: Part C Medicare Part D Plans Medicare Supplement Plans (Medigap) Dental and Vision Coverage CareCare What to Know Getting Better Care Preventive Health Find Care Medicare Caregiver Resources SupportSupport Login Registration (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. Administrative. Inpatient services and nonparticipating providers always require prior authorization. Decide on what kind of signature to create. In Indiana: Anthem Insurance Companies, Inc. Prior authorization requirements will be added for the following codes: Not all PA requirements are listed here. Use the Prior Authorization tool within Availity, or Contact Provider Services To submit a precertification request: Log in to Availity. Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. For costs and complete details of the coverage, please contact your agent or the health plan. Code pairs reported here are updated quarterly based on the following schedule. Contact will be made by an insurance agent or insurance company. endstream endobj startxref Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. Effective 01/01/2022 - 09/17/2022; Prior Authorization Procedure Codes List for ASO Plans. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. Prior authorization requirement changes effective June 1, 2022 Mar 1, 2022 State & Federal / Medicare On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. Contact 866-773-2884 for authorization regarding treatment. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Anthem HealthKeepers Plus Provider Manual, Long-term Services and Supports Authorization Guide. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Most PDF readers are a free download. In addition, some sites may require you to agree to their terms of use and privacy policy. Prior Authorization for Certain Hospital Outpatient Department (OPD) Services Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items Review Choice Demonstration for Home Health Services Return to Top Access the BH Provider Manuals, Rates and Resources webpage here. Independent licensees of the Blue Cross and Blue Shield Association. The services marked with an asterisk (*) only require Pre-Service Review for members enrolled in BlueChoice products if performed in an outpatient setting that is on the campus of a hospital. To view the medical policies associated with each service, click the link or search for the policy number in the Medical Policy Reference Manual. Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification. Mar 1, 2022 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. Medicaid Behavioral/Physical Health Coordination. Anthem offers great healthcare options for federal employees and their families. Contact 866-773-2884 for authorization regarding treatment. Independent licensees of the Blue Cross Association. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. You can also check status of an existing request and auto-authorize more than 40 common procedures. Start by choosing your patient's network listed below. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. We look forward to working with you to provide quality service for our members. Select Patient Registration from the top navigation. Fax medical prior authorization request forms to: 844-864-7853 In Connecticut: Anthem Health Plans, Inc. Commercial Prior Authorization Summary and Code Lists Please reference the Blues & CDHP Products Prior Authorization List on the Prior Authorization webpage. Scroll down to the table of contents. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). CareFirst Commercial Pre-Service Review and Prior Authorization. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). Or Community Supports under CalAIM are voluntary wrap-around services or settings available to members as a substitute for utilization of other services that focus on medical and/or needs that arise from social determinants of health. Enhanced Care Management (ECM) under CalAIM is a care management benefit that is community-based and provides a whole person approach to care that addresses the clinical and nonclinical needs of members with the most complex medical and social needs. We also support our providers with access to information about our plans and member benefits, news and updates, training materials and guides and other helpful resources. Prior Authorization Contact Information Providers and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal) Phone: 1-888-831-2246 Hours: Monday to Friday, 8 a.m. to 5 p.m. Fax: 1-800-754-4708 Start by choosing your patient's network listed below. Please Select Your State The resources on this page are specific to your state. Not connected with or endorsed by the U.S. Government or the federal Medicare program. We look forward to working with you to provide quality services to our members. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Medicaid benefits to enrollees. Drug list/Formulary inclusion does not infer a drug is a covered benefit. On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. We've provided the following resources to help you understand Empire's prior authorization process and obtain authorization for your patients when it's . Customer Care Center hours are Monday to Friday 7 a.m. to 7 p.m. After hours, verify member eligibility by calling the 24/7 NurseLine at. The purpose of this communication is the solicitation of insurance. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Use of the Anthem websites constitutes your agreement with our Terms of Use. Third-Party Liability (TPL) Forms. Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. View the list of services below and click on the links to access the criteria used for Pre-Service Review decisions. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. The form contains important information regarding the patient's medical history and requested medication which Anthem will use to determine whether or not the prescription is included in the patient's health care plan. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. We encourage providers to use This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. HealthKeepers, Inc. recommends submitting prior authorization requests for Anthem HealthKeepers Plus members via Interactive Care Reviewer (ICR), a secure Utilization Management tool available in Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. 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. Rx Prior Authorization. Choose My Signature. The BH prior authorization policy is outlined in the BH Provider Manual and can be accessed by following the instructions below. The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. This list may vary based on account contracts and should be verified by contacting 1-866-773-2884. Please check your schedule of benefits for coverage information. 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. To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. %%EOF Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number, which can be found here. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Please check your schedule of benefits for coverage information. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services (CMS) guidelines, including definitions and specific contract provisions/exclusions take precedence over these precertification rules and must be considered first when determining coverage. Medicare Advantage. Forms and information about pharmacy services and prescriptions for your patients. This tool is for outpatient services only. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. Do not sell or share my personal information. 1 Cameron Hill Circle, Chattanooga TN 37402-0001, Change of Ownership and Provider ID Number Change Information. In Indiana: Anthem Insurance Companies, Inc. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). This new site may be offered by a vendor or an independent third party. Long-Term Care (LTC) Forms. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Nov 1, 2021 ) refer to your, Access eligibility and benefits information on the, Use the Prior Authorization Lookup Tool within Availity or. Electronic authorizations. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Details about new programs and changes to our procedures and guidelines. In the event of an emergency, members may access emergency services 24/7. The prior authorization information in this notice does not apply to requests for HMO members. To learn more about required Colorado timelines for decisions regarding PA requests, please click, The Colorado Prescription Drug Prior Authorization Request form, The New Hampshire Prescription Drug Uniform Prior Authorization Request Form. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. 2020 copyright of Anthem Insurance Companies, Inc. HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. Visit our PharmacyInformation page for formulary information and pharmacy prior authorization forms. CoverKids. 711. Please use the For your convenience, we've put these commonly used documents together in one place. PA requirements are available to contracted providers on the provider websiteat Medicare Advantage Providers | Anthem.com > Login or by accessing Availity. Please refer to the criteria listed below for genetic testing. CareFirst does not guarantee that this list is complete or current. U.S. Department of Health & Human Services, National Association of Insurance Commissioners, Medicare Complaints, Grievances & Appeals. 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. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. Providers should continue to verify member eligibility and benefits prior to rendering services. You'll also find news and updates for all lines of business. 844-912-0938 Email: OhioMedicaidProvider@anthem.com Prior authorization resources and contact information Services Requiring Prior Authorization Inpatient prior authorization fax numbers Physical health: 877-643-0671 Behavioral health: 866-577-2184 Medicaid prior authorization: 800-964-3627 Outpatient prior authorization fax numbers Commercial. Anthems PriorAuthorizationLookupToolOnlinecan assist with determining a codes prior authorization requirements. State & Federal / Medicare. If you have any questions, call the number on the members ID card. 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. Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. In Ohio: Community Insurance Company. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. Here youll find information on the available plans and their benefits. Prior Authorization. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). 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