*If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. 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. What you need to know about the disease and our coverage commitment. At-home diagnostic tests can be purchased over the counter online, at a local pharmacy, or from a big-box store. The electronic process is the quickest way to get the claims to Anthem. ET. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. background-color: #7fcdbb; We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. 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. You may also receive a bill for any charges not covered by your health plan. The cost-sharing waiver includes copays, coinsurance and deductibles. The waivers apply to members who have individual, employer-sponsored, Medicare and Medicaid plans. COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. Steps you can take to protect yourself and others from COVID-19: Its best to follow the CDCs recommendations for using a facemask. Hydroxychloroquine and chloroquine will be covered only for FDA-approved indications: Visit the Division of Health Care Financing and Policy website at 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. 155 0 obj <>stream No. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. Confusion; bluish lips or face; or unconsciousness. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. An attending health care provider may order a test. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. They include fever, cough, and shortness of breath. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. If your doctor offers telehealth visits, your plan will pay for those, too. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. 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. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Please log in and update your communication preferences to make sure you receive the latest information. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. No prior authorizations for diagnostic tests and covered services. This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. Please check the CDC for the most up-to-date list of symptoms. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Findings. . What codes would be appropriate for COVID-19 lab testing? Call the National Information Center weekdays from 8 a.m. to 8 p.m. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. 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. We will support you and help you get the care you need. %PDF-1.7 % If your doctor isnt available for some reason, well help you find alternate care. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. 3. Who can order a test? 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. Your member ID card is your key to using your medical plan benefits. If you are not, please use our Test Site Finder to learn about options near you. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. All Rights Reserved. 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 Symptoms can be mild to severe. Plus, we will keep you updated as things develop. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. 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? Leading the way in health insurance since 1929. 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. Find free and reduced-cost support for food, transportation, housing, health and more. We'll also explore the additional care and support available for your protection and everyday needs. Here is what the CDC recommends. Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. 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. 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 . COVID-19 testing remains an important part of keeping our families and communities safe. For more information, view our privacy policy. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. cost sharing for COVID-19 diagnostic tests as deemed medically necessary by a healthcare clinician who has made an assessment of a patient, including serology or antibody tests, for members of our employer-sponsored, individual, Medicare and Medicaid plans. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. 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. The best way to prevent infection is to get fully vaccinated against COVID-19. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Check out the changes and updates to our plan in 2023. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment Anthem will process the claim as if there is no member cost sharing, as it does, for example, with preventive health services. A few things to know: Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is coveredunder certain conditions. Check the. 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. 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. whQf C4[IiKd"3\D.IK^C]&zD"V2. 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. In Ohio: Community Insurance Company. Heres everything you need to know about it. CMS has provided the Medicare guideline to use the CS modifier: Error! Effective May 1, 2021, for members of our fully-insured employer and individual plans, as well as self-funded plans, Anthem will reimburse for the administration of COVID-19 FDA-approved vaccines at a rate of $40 per administration. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. 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. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. 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). Your plan will pay for telehealth visits with your doctor through June 15. For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. At-home test kits from Anthem: Are FDA-authorized. They are for people who have no symptoms of COVID-19 and no known or suspected exposure to people who have COVID-19. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. 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. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? The Nevada Department of Health and Human Services (DHHS) and its Divisions, including the Division of Health Care Financing and Policy (DHCFP), are concerned about the effect of the pandemic on rates of anxiety, depression and suicide among youth. COVID-19 is a new strain of coronavirus that causes a highly contagious infection. For telehealth services rendered by a facility provider, report the CPT/HCPCS code with the applicable revenue code as would normally be done for an in-person visit, and also append either modifier 95 or GT. Otenti said if someone has been near a person with COVID-19 within a two-week time frame, there is also good reason to test for the virus . Anthem covers COVID-19 diagnostic tests for all members with no out-of-pocket costs. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Anthem is committed to making sure you can get the care you need. See how the Centers for Disease Control and Prevention (CDC) is closely monitoring the COVID-19 outbreak. 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. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. For non-COVID-19 tests (like flu, RSV, etc.) The most common early symptoms appear between 2 and 14 days after being infected. Anthem.com and Anthems COVID-19 site (https://www.anthem.com/blog/member-news/how-to-protect/) are great resources for members with questions and are being updated regularly. 24/7 access is provided at no cost. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. COVID-19 vaccines are safe and effective. 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. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Members can call the number on the back of their identification card to confirm coverage. Payment for COVID-19 testing services on or after January 1, 2022. Navigate COVID-19 challenges like social isolation and job loss with a free mental health resource hub, powered by Psych Hub and supported by Anthem. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. font-size: 50px; If you have a Medicaid plan with us, you do not have to pay anything for the COVID-19 test or the doctor visit to get the test. Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. Anthems affiliated health plans are committed to help provide increased access to care, while eliminating costs and help alleviate the added stress on individuals, families and the nations healthcare system. How can a provider submit Anthems Roster Billing claim form? 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. If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Out-of-network coverage will be provided where required by law. Read verified patient reviews and make an appointment instantly. The over-the-counter tests give results within 30 minutes. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. 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. Pain or pressure in the chest that wont go away. By continuing to use this website, you consent to these cookies. cdc.gov/coronavirus/2019-ncov/about/index.html. No cost share for diagnostic tests or treatment. Serving California. 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. Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. If you have questions or would like help finding testing, please call the Member Services number on your ID card. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of a pandemic? Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Future updates regarding COVID-19 will appear in the monthly Provider News publication. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. Thats why we are committed to ensuring our members who are dealing with a diagnosis of COVID-19 can easily access the care they need.. 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. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. From home the most common early symptoms appear between 2 and 14 days after infected. The counter Online, at a local pharmacy, or have difficulty.. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of determining the for... Electronic process is the quickest way to get fully vaccinated against COVID-19 our and! 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