For fully-insured commercial health plans issued in Colorado, Anthem will cover diagnostic lab tests for flu, respiratory syncytial virus (RSV), and others as required by law when determining the need for COVID-19 testing. Cant reach your doctor? 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. Reimbursement for COVID-19 testing performed in a participating hospital emergency room or inpatient setting is based on existing contractual rates inclusive of member cost share amounts waived by Anthem. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Effective from March 19, 2020, through May 31, 2021, unless a longer period is required by law, Anthem will cover telephone-only medical and behavioral health services from in-network providers and out-of-network providers when required by state. The visit and test are covered whether you get care in a doctors office, urgent care center or emergency department. Additionally, our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part to further support our stakeholders. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. We are not seeing any impacts to claims payment processing at this time. Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301. 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. In Colorado, is Anthem covering remote monitoring services in addition to telehealth via video + audio and telephonic-only visits? For more information, view our privacy policy. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). Providers do not need to notify Anthem of temporary addresses for providing healthcare services during the COVID-19 emergency. FEP knows many of you have serious concerns and questions regarding COVID-19 (coronavirus), especially as it continues to significantly impact our daily lives. Download the Sydney Health app. They also are for people who have no symptoms but know or suspect that they have recently been exposed to someone who has COVID-19. The cost-sharing waiver includes copays, coinsurance and deductibles. The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. Several recent media reports have focused on new and existing antiviral drugs being tested for use in treating COVID-19. Effective March 17, 2020, through September 30, 2020, unless a longer period is required by law, Anthems affiliated health plans will waive member cost share for telehealth (video + audio) in-network visits, including visits for behavioral health, for our fully-insured employer plans and individual plans. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. Symptoms can be mild to severe. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. 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. Please check the CDC for the most up-to-date list of symptoms. 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. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. 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. 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. The Department would like to bring to your attention the importance of the role you play as a provider in mental health screening and early identification of mental and behavioral health difficulties. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. Will Anthem allow Roster Billing for the COVID-19 vaccine? margin-bottom: 40px; Please review the Medicare and Medicaid specific sites noted below for details about these plans. How does my plan cover the over-the-counter test? Heres everything you need to know about it. Find free videos and tools that address topics like depression and anxiety in a helpful, sympathetic way. 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. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of a pandemic? Telemedicine not only helps members get the care they need, but helps reduce the spread of the coronavirus protecting the health of our members and the doctors and nurses who care for them. Our standard health plan contracts do not have exclusions or limitations on coverage for services for the treatment of illnesses that result from a pandemic. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. At-home diagnostic tests can be purchased over the counter online, at a local pharmacy, or from a big-box store. 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. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? No, prior authorization is not required for diagnostic services related to COVID-19 testing. %%EOF Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? In general, it is recommended people get tested if they have symptoms including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat. Reimbursement for over-the-counter tests. To help address care providers questions, Anthem has developed the following updates and frequently asked questions. Anthem is monitoring COVID-19 developments and what they mean for our associates and those we serve. Cost shares will be waived for in-network providers only. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. Check your COVID-19 benefits by using the Sydney Health or Engage Wellbeing mobile app, logging into anthem.com/ca, or calling the Member Services number on your ID card. We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment Anthem members will receive the COVID-19 vaccination at no cost, Anthem will help you coordinate COVID-19 care, Anthems alternative virtual care offerings, Prescription Medications and Pharmacy Services, Take advantage of emotional and mental health support. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. What Are Your Thoughts On The Vaccines Against Covid-19? Anthem is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. Your member ID card is your key to using your medical plan benefits. Ordering at-home test kits from Anthem. This modifier should be used for COVID-19 evaluation and testing services in any place of service. Anthem Blue Cross and Blue Shield Healthcare Solutions Member. If you receive care from a doctor or healthcare provider not in your plan's network, your share of the costs may be higher. All Rights Reserved. Were sharing information about how you can protect yourself and the people you care about. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. Use the. COVID-19 is a new strain of coronavirus that causes a highly contagious infection. color: #ffffff; 3. Who can order a test? who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes. Clean and disinfect items and surfaces you touch . 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 . 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. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Please discuss additional questions about COVID-19 treatments and medicines with your doctor. While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. Our coverage commitment is to ensure our members can quickly access the right care at the right time. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? Taking care of your emotional health is important during this stressful time. 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! People who are diagnosed with COVID-19 may have long-term symptoms. How can a provider submit Anthems Roster Billing claim form? For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. 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. For full details onbenefits, services and network coveragewhich may vary by health planfind each BCBS companys statement below: The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. You may also receive a bill for any charges not covered by your health plan. 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