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. Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. Your member ID card is your key to using your medical plan benefits. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. 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. Get the latest news and information from the CDC at 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. Leading the way in health insurance since 1929. Click below for the latest information for providers: The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the Novel Coronavirus (COVID-19) pandemic. Please check the CDC for the most up-to-date list of symptoms. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. Members can call the number on the back of their identification card to confirm coverage. Anthem members also can call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse about health questions. Cost sharing will be waived for members using Anthems authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. Research shows the COVID-19 vaccination will help keep you from getting COVID-19. That includes older adults, people living with disabilities, and those with chronic medical conditions like diabetes, and heart, lung or kidney disease. Heres everything you need to know about it. endstream endobj 112 0 obj <>/Metadata 8 0 R/Pages 109 0 R/StructTreeRoot 23 0 R/Type/Catalog/ViewerPreferences 133 0 R>> endobj 113 0 obj <>/MediaBox[0 0 612 792]/Parent 109 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 114 0 obj <>stream Cover your cough or sneeze with a tissue, and throw away the tissue. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. Nevada Department of Health and Human Services Directors Office Urges Youth Screening (November 23, 2020), COVID-19 information from Anthem Blue Cross and Blue Shield Healthcare Solutions (October 22, 2020), Attention All Providers: New Phase 3 Provider Relief Funding Available (October 13, 2020), Deadline for Provider Relief Fund Has Been Extended to August 3, 2020 (July 23, 2020), HHS announces additional distributions from the Provider Relief Fund to eligible Medicaid and CHIP providers (6/15/2020), COVID-19 update: Guidance for telehealth/telephonic care for behavioral health services (June 9, 2020), Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment, COVID-19 update: Anthem Blue Cross and Blue Shield Healthcare Solutions suspends select prior authorization rules and announces significant policy adjustments in response to unprecedented demands on health care providers, Listen now! margin-bottom: 40px; If you are not, please use our Test Site Finder to learn about options near you. 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. Taking care of your emotional health is important during this stressful time. 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. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Horizon Blue Cross Blue Shield of New Jersey, Your Guide to No-Cost Testing and Treatment as COVID-19 Surges, COVID-19 Information Hub section on testing, Site-Neutral Payments Would Save Nearly $500 Billion Over 10 Years, Blue Cross Blue Shield Association Statement on Medicare Advantage Risk Adjustment Validation Rule, Blue Cross Blue Shield Association Policy Solutions Could Lower Health Care Costs by $767 Billion, Blue Cross Blue Shield Companies Form Synergie Medication Collective, a New Venture to Radically Improve Affordability and Access to Costly Medications for Millions of Americans, Congress Passes Meaningful Changes to Expand Mental Health Support, Improve Maternal Health, and Lower Costs for Consumers, Blue Cross and Blue Shield of Louisiana Offers Services to Members Affected by Hurricane Ida, Blue Cross Of Idaho And The Blue Cross Of Idaho Foundation For Health Commit To Expanding Health Equity Across Idaho, Blue Cross Blue Shield of Wyoming Announces New Board Member, James G. Springfield Named President of Blue Cross and Blue Shield of Texas. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? The U.S. Department of Health and Human Services (HSS) announced the distribution of approximately $15 billion from the Provider Relief Fund to eligible providers who participate in state Medicaid and the Children's Health Insurance Program (CHIP): On June 9, 2020, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Childrens Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. Reimbursement for over-the-counter tests. Providers should continue to verify eligibility and benefits for all members prior to rendering services. People with COVID-19 have had a wide range of reported symptoms, ranging from mild symptoms to severe illness. Can I visit the emergency room for a test? Stay six feet away from others, avoiding crowds and poorly ventilated spaces. whQf C4[IiKd"3\D.IK^C]&zD"V2. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. Check out the changes and updates to our plan in 2023. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? All Rights Reserved. View insurance accepted, education, awards, and specialties for NeuMed Modern Urgent Care + IV Therapy - Heights - Virtual. padding: 0.6rem; Anthem is a registered trademark of Anthem Insurance Companies, Inc. Update your email address and choose the email option under Helpful Information to stay informed on COVID-19. To avoid paying any out-of-pocket costs, you must go to an in-network retail pharmacy, take the testing kit to the pharmacy counter and provide your Service Benefit Plan member ID card to the pharmacist and/or pharmacy technician. Your health is important. If your doctor recommended you get tested, find a nearby COVID-19 testing site. Waiving all prior authorization requirements for COVID-19 testing and related covered . Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Prior authorization is not required for COVID-19 testing. Talk to your doctor to see if a 90-day supply would work for you. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. 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. Members in California and Nevada: You can also make an appointment withLiveHealth Online and see a doctor from your smartphone. Here are some tips: Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. Be sure to log in and check your communication preferences. Today, unless otherwise required under state and federal mandates as detailed below, Anthem health plans will suspend select prior authorization (PA) requirements, member cost sharing, claims review and handling protocols to allow health care providers to focus on caring for patients diagnosed with COVID-19: We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. 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. 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. hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV *Applies only for members with Anthem pharmacy benefits. The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. 2023 Blue Cross Blue Shield Association. Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. What Are Your Thoughts On The Vaccines Against Covid-19? Are COVID-19 tests covered? Cover your coughs and sneezes with tissues; discard the tissues. Need coverage now due to job loss? 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. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. We have resources and partners to help you handle not just everyday needs, but extra ones you may be facing in this outbreak. COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing Yes, we will cover COVID-19 home testing kits that are available over the counter. Plus, we will keep you updated as things develop. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. Do a video or phone visit with a doctor or therapist from home. www.cdc.gov/coronavirus. cost sharing for telephonic-only in-network visits from March 19, 2020, through January 11, 2023, for fully-insured employer-sponsored, individual and Medicaid plans. 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. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. independent licensees of the Blue Cross and Blue Shield Association. Future updates regarding COVID-19 will appear in the monthly Provider News publication. What codes would be appropriate for COVID-19 lab testing? No. Use of the Anthem websites constitutes your agreement with our Terms of Use. At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. What codes would be appropriate to consider for telehealth (audio and video) for physical, occupational, and speech therapies? Pain or pressure in the chest that wont go away. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. You'll need to submit them when you apply for reimbursement. Additionally, members who have a pharmacy plan that includes a 90-day mail-order benefit should talk to their doctor about whether changing from a 30-day supply to a 90-day supply of their prescriptions is appropriate. If youre experiencing symptoms or if your doctor recommends a test, use our COVID-19 Test Site Finder to search your ZIP Code and find testing options near you. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. 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. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) Please review the Medicare and Medicaid specific sites noted below for details about these plans. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. Mention they have COVID-19 (or symptoms of it). How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? For more information, view our privacy policy. For non-COVID-19 tests (like flu, RSV, etc.) Download the v-safe app for personalized health check-ins after you receive your first COVID-19 vaccine. Wash your hands and use hand sanitizer before and after touching someone or any mobility devices (canes, a walker) or other equipment. 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. This includes visits for behavioral health for our fully insured employer plans, individual and Medicaid plans, where permissible. None of these drugs is approved for use with COVID-19, and many are still being investigated. How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? Anthem is a registered trademark. No, prior authorization is not required for diagnostic services related to COVID-19 testing. cost sharing for visits where the purpose of the visit is to be screened and/or tested for COVID-19, regardless of whether test is administered, beginning March 18, 2020, for members of our employer-sponsored, individual, Medicare and Medicaid plans. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. 0 If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. No. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Anthem Blue Cross and Blue Shield Healthcare Solutions Member. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. Our coverage commitment is to ensure our members can quickly access the right care at the right time. We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. 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 . Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. To help reduce the burden on the states health care facilities and ensure members get the care they need when they need it, the cost-sharing waiver also applies totelemedicine visits, includingtelephonic visits. Please discuss additional questions about COVID-19 treatments and medicines with your doctor. The health of our members is always our top priority. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. Diagnostic tests are for people who have symptoms of COVID-19. Schedule a COVID-19 test with your doctor. Psych Huboffers resources to help with pandemic-related stress such as social isolation, coping with grief and loss, and other mental health issues. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. Wash your hands or use hand sanitizer when entering their house or room. 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. 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. 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. Similar to a cold or the flu. Only visit the ER or call 911 if you're experiencing life-threatening symptoms. An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. 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. You may also receive a bill for any charges not covered by your health plan. 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. Anthem members have access to telehealth 24/7 through LiveHealth Online. Waiving all prior authorization requirements for COVID-19 testing and related covered services. 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. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. 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. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Anthem members wont have out-of-pocket costs for the vaccine during this national public health emergency. Many plans include telephone care benefits during this public health emergency. If your doctor isnt available for some reason, well help you find alternate care. Cost shares will be waived for in-network providers only. 24/7 access is provided at no cost. Administration for Community Living: COVID-19 and what you need to know, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), You can still use in-person diagnostic COVID-19 testing sites. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . Ordering at-home test kits from Anthem. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. Arrive in 2 to 5 business days. 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. The best way to prevent infection is to avoid being exposed to the virus. For the Health of America. 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. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread. 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. These may include your doctor's office, a pharmacy or health clinic, or an urgent care center. -webkit-border-radius: 50%; Lets look at the latest information on COVID-19 and how your health care plan can help. 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