Prior authorization to confirm medical necessity is required for certain services and benefit plans as part of our commitment to help ensure all Blue Cross and Blue Shield of Illinois (BCBSIL) members get the right care, at the right time, in the right setting. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Providers and staff can also contact Anthem for help with prior authorization via the following methods: Pharmacy Prior Authorization Center for Medi-Cal: *For Medicare-Medicaid Plan pharmacy requests, please contact Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Care at 855-817-5786. BlueCross BlueShield of Tennessee uses a clinical editing database. 494 0 obj <>stream For your convenience, we've put these commonly used documents together in one place. Forms and information about behavioral health services for your patients. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. As your health needs evolve, our diverse plans are designed to evolve with you. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Do not sell or share my personal information. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Prior Authorization Contact Information Providers and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal) Phone: 1-888-831-2246 Hours: Monday to Friday, 8 a.m. to 5 p.m. Fax: 1-800-754-4708 Contact 866-773-2884 for authorization regarding treatment. Providers are responsible for verifying prior authorization requirements before services are rendered. Call our Customer Service number, (TTY: 711). Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Anthem offers great healthcare options for federal employees and their families. Contact will be made by an insurance agent or insurance company. Medicare Coverage with Anthem Medicare Information Medicare Coverage and Enrollment Turning 65 Medicare Advantage Plans: Part C Medicare Part D Plans Medicare Supplement Plans (Medigap) Dental and Vision Coverage CareCare What to Know Getting Better Care Preventive Health Find Care Medicare Caregiver Resources SupportSupport Login Registration Decide on what kind of signature to create. The list below includes specific equipment, services, drugs, and procedures requiring review and/or supplemental documentation prior to . ) refer to your, Access eligibility and benefits information on the, Use the Prior Authorization Lookup Tool within Availity or. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. Please refer to the criteria listed below for genetic testing. Medical Injectable Drugs: 833-581-1861. Providers should continue to verify member eligibility and benefits prior to rendering services. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. View the list of services below and click on the links to access the criteria used for Pre-Service Review decisions. In Maine: Anthem Health Plans of Maine, Inc. Information about benefits for your patients covered by the BlueCard program. Drug list/Formulary inclusion does not infer a drug is a covered benefit. Please note: This change is not applicable to the members enrolled in the Mercy Co-worker Plan as they have a customized prior authorization list. Follow the step-by-step instructions below to design your anthem forms: Select the document you want to sign and click Upload. Prior Authorization Requirements. Effective 01/01/2022 - 09/17/2022; Prior Authorization Procedure Codes List for ASO Plans. %PDF-1.6 % On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. In Indiana: Anthem Insurance Companies, Inc. The "Prior authorization list" is a list of designated medical and surgical services and select prescription Drugs that require prior authorization under the medical benefit. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. There are three variants; a typed, drawn or uploaded signature. Note: Blue High Performance NetworkSM (BlueHPNSM) members have limited benefits at the University of Maryland Medical System Downtown Campus. The prior authorization information in this notice does not apply to requests for HMO members. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Use of the Anthem websites constitutes your agreement with our Terms of Use. AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX. Here you'll find information on the available plans and their benefits. Bundling Rationale (Claims filed before Aug. 25, 2017). In Ohio: Community Insurance Company. Contact 866-773-2884 for authorization regarding treatment. To get started, select the state you live in. Any drugs, services, treatment, or supplies that the CareFirst medical staff determines, with appropriate consultation, to be experimental, investigational or unproven are not covered services. With three rich options to choose from, weve got you covered. PPO outpatient services do not require Pre-Service Review. Fax medical prior authorization request forms to: 844-864-7853 ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. 711. This approval process is called prior authorization. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. We look forward to working with you to provide quality services to our members. These manuals are your source for important information about our policies and procedures. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Prior Authorization for Certain Hospital Outpatient Department (OPD) Services Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items Review Choice Demonstration for Home Health Services Return to Top 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. We've provided the following resources to help you understand Empire's prior authorization process and obtain authorization for your patients when it's . In Indiana: Anthem Insurance Companies, Inc. Medical Clearance Forms and Certifications of Medical Necessity. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Not connected with or endorsed by the U.S. Government or the federal Medicare program. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Maine: Anthem Health Plans of Maine, Inc. Nov 1, 2021 Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. This tool is for outpatient services only. Availity, LLC is an independent company providing administrative support services on behalf of HealthKeepers, Inc. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). We also support our providers with access to information about our plans and member benefits, news and updates, training materials and guides and other helpful resources. Visit our PharmacyInformation page for formulary information and pharmacy prior authorization forms. The latest edition and archives of our quarterly quality newsletter. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (in other words, experimental procedures, cosmetic surgery, etc. Use Availity's electronic authorization tool to quickly see if a pre-authorization is required for a medical service or submit your medical pre-authorization request. Providers should call the prior authorization number on the back of the member ID card. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. Access the BH Provider Manuals, Rates and Resources webpage here. Select Patient Registration from the top navigation. Start by choosing your patient's network listed below. Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022. Noncompliance with new requirements may result in denied claims. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Please Select Your State The resources on this page are specific to your state. endstream endobj 452 0 obj <. Online - The AIM ProviderPortal is available 24x7. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Enhanced Care Management (ECM) under CalAIM is a care management benefit that is community-based and provides a whole person approach to care that addresses the clinical and nonclinical needs of members with the most complex medical and social needs. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Contracted and noncontracted providers who are unable to access Availity may call the number on the back of the members ID card. 451 0 obj <> endobj In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. Please check your schedule of benefits for coverage information. A prior approval is required for the procedures listed below for both the FEP Standard and Basic Option plan and the FEP Blue Focus plan. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. We look forward to working with you to provide quality service for our members. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Sign up to receive personalized communication from us, and we'll refine it to meet your preferences. An Anthem (Blue Cross Blue Shield) prior authorization form is what physicians will use when requesting payment for a patient's prescription cost. Medicare Advantage. We encourage providers to use CareFirst does not guarantee that this list is complete or current. One option is Adobe Reader which has a built-in reader. CoverKids. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Additionally, providers can use this tool to make inquiries on previously submitted requests, regardless of how they were sent (phone, fax, ICR or another online tool). Select Auth/Referral Inquiry or Authorizations. The services marked with an asterisk (*) only require Pre-Service Review for members enrolled in BlueChoice products if performed in an outpatient setting that is on the campus of a hospital. Large Group You may also view the prior approval information in the Service Benefit Plan Brochures. 844-912-0938 Email: OhioMedicaidProvider@anthem.com Prior authorization resources and contact information Services Requiring Prior Authorization Inpatient prior authorization fax numbers Physical health: 877-643-0671 Behavioral health: 866-577-2184 Medicaid prior authorization: 800-964-3627 Outpatient prior authorization fax numbers 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. In Connecticut: Anthem Health Plans, Inc. 477 0 obj <>/Filter/FlateDecode/ID[<530E5E682DBDAA468541E11BFAD96BAD>]/Index[451 44]/Info 450 0 R/Length 122/Prev 255106/Root 452 0 R/Size 495/Type/XRef/W[1 3 1]>>stream Use the Prior Authorization tool within Availity, or Contact Provider Services To submit a precertification request: Log in to Availity. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Providers should continue to verify member eligibility and benefits prior to rendering services. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. Home Employer Federal Employees Blue Cross And Blue Shield Service Benefit Plans Medical Plans Independent licensees of the Blue Cross and Blue Shield Association. Long-Term Care (LTC) Forms. Use of the Anthem websites constitutes your agreement with our Terms of Use. Launch Provider Learning Hub Now Claims Overview Forms Electronic Data Interchange (EDI) Or Administrative. hb``` ce`a`Y5 bR;)/}ksN}J^dcZ9@ @Hw400P`a Pl fKU0 e`c cpIqc1$frf3Hf6S\k{3*0ue`dzAyF ~ H00#9 L You can also check status of an existing request and auto-authorize more than 40 common procedures. In 2020, Part B step therapy may apply to some categories . Anthem offers great healthcare options for federal employees and their families. The form contains important information regarding the patient's medical history and requested medication which Anthem will use to determine whether or not the prescription is included in the patient's health care plan. Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. You can use the PriorAuthorizationLookupTool or reference the provider manual to determine if authorization is needed. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. In the event of an emergency, members may access emergency services 24/7. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Information to help you maximize your performance in our quality programs. Commercial non-HMO prior authorization requests can be submitted to AIM in two ways. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Some procedures may also receive instant approval. The site may also contain non-Medicare related information. Here youll find information on the available plans and their benefits. BCBS FEP Vision covers frames, lenses, and eye exams. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. If you have any questions, call the number on the members ID card. You can also refer to the provider manual for information about services that require prior authorization. For costs and complete details of the coverage, please contact your agent or the health plan. This list may vary based on account contracts and should be verified by contacting 1-866-773-2884. Prior authorization requirement changes effective June 1, 2022 Mar 1, 2022 State & Federal / Medicare On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. * Once logged in to Availity at http://availity.com, select Patient Registration > Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry, as appropriate. Create your signature and click Ok. Press Done. FEP Medications requiring online prior authorization, Intravenous Immune Globulin (IVIG) Therapy, Stereotactic Radiosurgery Using Gamma Rays, Surprise Billing - Out-Of-Network Provider Notice, Ambulance -elective air transport only (10.0.005), Behavioral Health and Substance Use Disorder (Milliman Care Guidelines), Repetitive Transcranial Magnetic Stimulation (TMS), Inpatient Behavioral Health and Substance Use Disorder, Home health care (Criteria defined in the employer group benefit contract), Home Infusion Therapy (Criteria defined in the employer group benefit contract), Hospice (Criteria defined in the employer group benefit contract), Inpatient rehabilitation (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care), Maternity Services- inpatient only, for stay greater than 48/96 hours (Criteria defined in the employer group benefit contract), Out-of-network services (Benefits available according to the member contract), Private Duty Nursing (Criteria defined in the employer group benefit contract), Skilled nursing facility admissions (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care). 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