If a medication is selected that is not on the drug list, the member will be responsible for the full cost of the drug. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. To stay covered, Medicaid members will need to take action. 1-877-258-0167 View listings below of the retail pharmacies that participate in our pharmacy networks. For help with AcariaHealth, call 1-800-511-5144 (TTY 1-800-955-8770), Monday through Friday, 8:00 a.m. to 10:00 p.m., Eastern time. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: We drive compliance to improve health and reduce costs. Get translation and interpretation services free of charge. We offer affordable health, dental, and vision coverage to fit your budget. The Pharmacy Home Program identifies members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances. endobj CVS Health ( NYSE: CVS ) is a coast-to-coast healthcare conglomerate comprised of retail / mail order. Click on the link below to view a complete list of pharmacies participating in the Advantage Network. Federal Employees Program If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. Automated information is available anytime. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). The automated system is available anytime. Search for specific text by using your Find function (Ctrl+F or Command+F). Your dashboard may experience future loading problems if not resolved. What you need to know about the coronavirus, COVID-19. These medications are delivered to your home or shipped to a local CVS pharmacy for pickup. P.O. Independent licensees of the Blue Cross and Blue Shield Association. 1-800-249-5103 8 a.m. to noon and 1 to 5 p.m. Medical Prior Authorization requests can be submitted through CoverMyMeds. Call Member Services at You can count on our guidance, education, and compassion throughout your entire course of treatment. Monday through Friday. 1-877-258-0167 Physicians and professionals: 1-800-344-8525 Get access to your agent portal. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. Just keep in mind you'll need to go through the prompts before you're connected to someone. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 1-800-482-5982 Contact will be made by an insurance agent or insurance company. Automated information is available anytime. 2005 - 2023 copyright of Anthem Insurance Companies, Inc. Log in at availity.com. Vision and hearing providers: 1-800-482-4047. You can write to us by matching your area code with the relevant mailing address. Hospitals or facilities: 1-800-249-5103. Grand Rapids, MI 49516-8753, Blue Cross Complete Claims Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? P.O. The Prior Authorization process allows for the request and approval of these medications. Customer service is available 8 a.m. to noon and 1 p.m. to 5 p.m. Monday through Friday. 20500 Civic Center Drive Optum Connections includes videos, virtual visits, support texts and more all designed to help you understand your condition, manage your treatment, and live your best possible life. Blue Cross Blue Shield of Michigan Your dashboard may experience future loading problems if not resolved. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Step 5:Tell the system the date of service provided. Monday through Friday, Care Management--Mail Code C355 Level 1: You can get prescriptions filled at Level 1 pharmacies for the same copay or percentage of the drug costs you usually pay as part of your prescription drug plan. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play. Providers should continue to submit for administration of the medication, but not bill for the medication itself. CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. stream To report fraud, waste or abuse, call our hotline: 1-800-437-3803 20500 Civic Center Drive In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Our resources vary by state. As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. Your online account is a powerful tool for managing every aspect of your health insurance plan. Medicare Complaints, Grievances & Appeals. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. We also offer infusion services with Optum Infusion Pharmacy. Call our Customer Service number, (TTY: 711). We believe the right drugs to cover are the ones that do the best job for our members and reduce the total cost of care. In Ohio: Community Insurance Company. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Box 7355 You can find yours by selecting your region below. With the Rx Choice Network, you can choose from two levels of coverage, helping to provide both savings and access: Level 1: You can get prescriptions filled at Level 1 pharmacies for the same copay or percentage of the drug costs you usually pay as part of your prescription drug plan. London, KY 40742. Jan 1, 2021 Not registered? You can count on our guidance, education, and compassion throughout your entire course of treatment. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. The Rx Choice Tiered Network may apply if: Advantage Network pharmacies (including all participating states), Provider network for hemophilia drug therapy, Provider network for hemophilia drug therapy (Georgia), Provider network for hemophilia drug therapy (Virginia). 3 0 obj We use drug lists, along with gaps-in-care messaging, to support overall member health. If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. By using targeted, concise communication, we help members make good health care choices and improve health outcomes. %PDF-1.5 We offer home delivery, as well as Retail 90 and Smart 90 pharmacy networks as options for members to fill up to a 90-day supply of their medications. Monday through Friday. Vision providers who can't access their account or need more information can read the Blue Vision Provider Summary Guide (PDF) to learn how to: Submit claims, appeals and attachments Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. Specialty drug list Anthem Blue Cross and Blue Shield Healthcare Solutions is contracted with Accredo as our exclusive pharmacy supplier for high-cost, specialty/injectable drugs that treat a number of chronic or rare conditions. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. Search for specific text by using your Find function (Ctrl+F or Command+F). Say "no" when asked if you have additional questions about the determination of a claim. IngenioRx Specialty Pharmacy provides your specialty medications. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. Get access to your online account. In Maine: Anthem Health Plans of Maine, Inc. 8 a.m. to 7 p.m. Explore our resources. 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. Box 230589 Specialty medications are used to treat these conditions and often require special storage or extra support. Specialty Pharmacy Benefits | Anthem Blue Cross Blue Shield Nevada Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. Submit prior authorization requestselectronicallythrough CoverMyMeds. We've gathered resources and tools to help you work as efficiently and productively as possible and do what you do best- care for our members. Taking time for routine mammograms is an important part of staying healthy. There, you can log in to refill, manage, and sign up for home delivery. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Price a medication, find a pharmacy,order auto refills, and more. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. If you have questions or need assistance, we're always here to help. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. Pharmacy Information for Providers. All specialty pharmacy prior authorization requirements will still apply and are the responsibility of the ordering provider. View our map (PDF). Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. Blue Cross Blue Shield of Michigan Refill and track your specialty drug prescriptions, pay online, and get live support. Register Now, Not registered? We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. Monday through Friday Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. Birmingham, AL 35238-0518. Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. We see how drugs work in our members real lives and help them make good health care choices. 2 0 obj Box 32593 Step 7:Listen to your claim's status, which includes the following information: Step 8: After listening to the claim's status, you'll have the following choices: The automated system is available anytime. The list of specialty pharmacy medications subject to the above will be posted on anthem.com for reference and is subject to change. Blue Cross Blue Shield of Michigan This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Southfield, MI 48075, 1-877-293-2788 You can also talk to your provider consultant. Box 312599 Monday through Friday. 1-888-826-8152 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., 2023. out of your benefits, find the best healthcare, and stay healthy. Fit your budget 2005 - 2023 copyright of Anthem insurance Companies, Inc. Wisconsin Anthem Blue Cross Blue of... About the coronavirus, COVID-19 health conditions routine mammograms is an important part of staying healthy Network pharmacies plan... It looks like you 're outside the United States, you may have lot! Is available 8 a.m. to 10:00 p.m., Eastern time policy has exclusions, limitations, and.. Is an important part of staying healthy impact on how members obtain non-specialty pharmacy medications at pharmacies... Function ( Ctrl+F or Command+F ) education, and compassion throughout your entire course of treatment should to. 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