P.O. Anthem is a registered trademark of Anthem Insurance Companies, Inc. 1-855-504-2583 Anthem Blue Cross (Anthem) is pleased to offer CVS Specialty* as our designated specialty pharmacy for specialty medications administered in the office or outpatient hospital setting. CVS Specialty and Hemophilia Treatment Centers on the list are considered in-network and will give you lower costs for your Factor treatment under the medical benefit. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). It looks like you're outside the United States. Providing care for those who need it most requires a team effort. See what specialty pharmacies are considered in-network. Monday through Friday, 1-800-431-1059 Detroit, MI 48226. 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. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. Cost-of-care and clinical programs focus on total costs, and we encourage medications that help to reduce those total costs. When clients have both our medical and pharmacy benefits, we can access members combined medical, pharmacy and lab dataplus member eligibility and benefit informationin order to create a holistic health care picture. Lets make healthy happen. Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. Choose your state below so that we can provide you with the most relevant information. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. If youre a professional provider office, you have access to a provider consultant. London, KY 40742. Your browser is not supported. Our clinical management program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 a.m. to 8 p.m. ET/CT, 7 a.m. to 7 p.m. MT/PT. 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. You can use our automated system to reach a representative to discuss your claim's outcome. When you're contracted with us you have access to a provider consultant. 1-800-762-2382 Say "claims" when the system asks why you're calling. Register now, or download the Sydney Health app to access your benefits, ID card, pharmacy info, and more. Both medical and pharmacy costs are our responsibility. Federal Employee Program providers and facilities: 1-800-840-4505. Find yours in our list ofphysician organization consultants (PDF). You can order by phone whether or not you're already a member. State and Federal Privacy laws prohibit unauthorized access to Member's private information. In Maine: Anthem Health Plans of Maine, Inc. Beginning, April 1, 2021, Anthem Blue Cross and Blue Shield (Anthem) is implementing a designated network for select specialty pharmacy medications administered in the office or the outpatient facility setting, Designated SRx Network. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. The resources on this page are specific to your state. Automated information is available anytime. Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. Grand Rapids, MI 49516-8710, BCN Advantage Claims Box 32593 Find a Medicare plan that fits your healthcare needs and your budget. 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. 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. Step 6:Tell the system the total amount charged. Providing care for those who need it most requires a team effort. 8 a.m. to noon and 1 to 5 p.m. We currently don't offer resources in your area, but you can select an option below to see information for that state. Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. %PDF-1.5 We currently don't offer resources in your area, but you can select an option below to see information for that state. Get access to your agent portal. The automated system is available anytime. Medicare Complaints, Grievances & Appeals. You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. Vision and hearing providers: 1-800-482-4047. Taking time for routine mammograms is an important part of staying healthy. To report fraud, waste or abuse, call our hotline: 1-800-437-3803 Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. Box 310166 In Ohio: Community Insurance Company. P.O. Available as CarelonRx core pharmacy network, the Advantage Network includes nearly 58,000 independent and well-known retail pharmacies and big box stores across the country. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . Monday through Friday. 2 0 obj Blue Care Network 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. Monday through Friday, Care Management--Mail Code C355 If your state isn't listed, check out bcbs.com to find coverage in your area. If you need additional guidance, read the Dentaquest Dental Manual (PDF). If you have any questions about your pharmacy benefits, call Pharmacy Member Services at 1-833-207-3120 (TTY 711) 24 hours a day, seven days a week. CVS Specialty helps patients with complex conditions manage their medications and live their best lives. As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. Medication is often one of them. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. 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. Detroit, MI 48232-0593, UB-04 claims If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. Monday through Friday In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims These pharmacies serve members with complex or chronic conditions. We encourage medications that improve patient health. Step 5: Tell the system the date of service. Pharmacy Information for Providers We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. Effective for dates of service March 1, 2022, and beyond, requests for the medications listed above and the clinical information submitted will be reviewed for both medical necessity of the medication itself (as is done Manage your medicine from anywhere with the Anthem mobile app With the free app, you can: Order refills Track orders View all prescriptions Download the app now: Page Last Updated: 06/09/21 Start a Live Chat with one of our knowledgeable representatives. 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). Contact customer service, Heritage Provider service: 1-800-252-2053. 2005 - 2023 copyright of Anthem Insurance Companies, Inc. % Explore programs available in your state. Products & Programs / Pharmacy. Get access to your employer portal. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. Call Member Services at Health equity means that everyone has the chance to be their healthiest. 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. 1-877-258-0167 We also offer infusion services with Optum Infusion Pharmacy. We currently don't offer resources in your area, but you can select an option below to see information for that state. We offer flexible group insurance plans for any size business. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. You can find yours by selecting your region: Not sure which region you're in? Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Specialty pharmacies are different. 3 0 obj By using targeted, concise communication, we help members make good health care choices and improve health outcomes. New member? x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ Monday through Friday. Blue Cross Blue Shield of Michigan This applies to all Anthem Indiana commercial members. Plus, you may qualify for financial help to lower your health coverage costs. Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). Medical and pharmacy strategies complement each other; theyre based on the same goals. Federal Employees Program The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. Our goal is to help improve your patients health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and knowledge. Here to Help You. Detroit, MI 48232-4248, Provider Inquiry 8 a.m. to 7 p.m. Note: The FEP phone system has a different set of prompts than the others. New member? Step 2 - In "Patient Information", provide the patient's full name, phone number, full address, date of birth, sex (m/f), height, and weight. If you misplace your medicine or it is stolen, contact your provider. 8:30 a.m. to 4:30 p.m. Get access to your agent portal.Register Now. Register Now, Not registered? The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. 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