cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. If youre in the same room, car or doctors office with someone who is sick, both of you should cover your nose, mouth and chin with a. The cost-sharing waiver includes copays, coinsurance and deductibles. To ensure you have access to the right care at the right time, FEP is waiving cost shares and prior authorization to support members care for COVID-19. Anthems fully-insured commercial plans issued in Colorado cover telehealth as required by applicable law. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. Blue Shield of California and Blue Shield of California Promise Health Plan are independent licensee s of the Blue Shield Association L52000-W-BSC-PHP (1/20) T11597 (4/21) Page 1 of 5 . Talk to your doctor to see if a 90-day supply would work for you. COVID-19 testing remains an important part of keeping our families and communities safe. Out-of-network coverage will be provided where required by law. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. Heres what the Centers for Disease Control and Prevention says about wearing a facemask. You can even get them through home delivery pharmacy. No. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Increasing access to prescription medications. COVID-19 vaccines are safe and effective. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. 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. The best way to prevent infection is to avoid being exposed to the virus. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? What codes would be appropriate to consider for a telehealth visit with a patient who wants to receive health guidance during the COVID-19 crisis? This information can be found in the, March 2023 Anthem Provider News - Colorado, February 2023 Anthem Provider News - Colorado, Working with Anthem webinars - January 2023 overview, Telephonic-only care allowance extended through April 11, 2023 - Colorado, January 2023 Anthem Provider News - Colorado, https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies, Allowed Virtual Services (Telehealth/Telemedicine), https://www.anthem.com/blog/member-news/how-to-protect/, https://www.anthem.com/docs/public/inline/COV19_BillRoster_ABCBS.pdf, Federal Resources Available for Care Providers and Employers in the Federal CARES Act, COVID-19 Information Colorado Publication RETIRED as of November 8, 2022. cost sharing for the treatment of COVID-19 from April 1, 2020, through January 31, 2021, for members of our fully-insured employer, Individual, Medicare Advantage and Medicaid plans. Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. Diagnostic tests are for people who have symptoms of COVID-19. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Kaiser found: 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue Shield of California, Care First, Cigna, CVS Group/Aetna, and Kaiser Permanente) are currently relying only on . A diagnostic test is used to determine if a person has COVID-19. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. www.cdc.gov/coronavirus. 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. How can I find a COVID-19 testing location? hbbd```b``:"@&@$2X&9 `2H2?bo X 2X* 0 * }X 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. How does my plan cover the over-the-counter test? Anthem will waive member cost shares for COVID-19 lab tests performed by participating and non-participating providers. Anthem recognizes the intense demands facing doctors, hospitals and all health care providers in the face of the COVID-19 pandemic. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. The protection of your privacy will be governed by the privacy policy of that site. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. 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. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) Be sure to log in and check your communication preferences. For more information, view our privacy policy. cdc.gov/coronavirus/2019-ncov/about/index.html. %PDF-1.7 % Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. 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. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? An airway and lung infection, similar to a cold. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently. 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. independent licensees of the Blue Cross and Blue Shield Association. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. Leading the way in health insurance since 1929. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Were sharing information about how you can protect yourself and the people you care about. Medicare Advantage and Medicare GRS plans are waived through February 28, 2021. cost sharing for telehealth services not related to the treatment of COVID-19 from Anthem's telehealth provider, LiveHealth Online, from March 17, 2020, through May 31, 2021, for our fully-insured employer, individual, and where permissible, Medicaid plans. Anthem will waive cost-sharing requirements for testing and the cost of the testing, and for emergency services related to COVID-19 screening or testing from any provider. To access your member services, please visit your BCBS company. Blue Shield and Blue Shield Promise will cover most COVID-19 tests at no out-of-pocket cost to you for specified plans noted below. Its part of the same family of coronaviruses that includes the common cold. 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. Anthem is committed to working with and supporting our contracted providers. 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. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website. When member cost sharing has been waived (where permissible) by Anthem as outlined in this FAQ for COVID-19 testing and visits associated screening and/or tested for COVID-19, telehealth (video + audio) services, and in-network telephonic-only services, how does that impact provider reimbursement? Member Discounts Take advantage of member-only discounts on health-related products and services. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. Find free videos and tools that address topics like depression and anxiety in a helpful, sympathetic way. People with COVID-19 have had a wide range of reported symptoms, ranging from mild symptoms to severe illness. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. In Connecticut: Anthem Health Plans, Inc. Do these guidelines apply to members enrolled in the Blue Cross and Blue Shield Service Benefit Plan commonly referred to as the Federal Employee Program (FEP) through the Federal Employees Health Benefits Program? 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. 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. Good health habits can also help prevent and fight COVID-19. We know how important it is to continue taking your prescriptions as directed by your doctor. How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? Get Reimbursed for Over-the-Counter COVID-19 Tests As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. If youre not sure whether your plan offers it, call us at the Member Services number on your ID. It lets you see a doctor through live chat or video on your phone, tablet, or computer. Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. 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. 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. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. The number one priority for Blue Cross Blue Shield (BCBS) companiesespecially as the nation faces this unprecedented health crisisis getting their members across the country the care they need. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. 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. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. That includes older adults, people living with disabilities, and those with chronic medical conditions like diabetes, and heart, lung or kidney disease. Go to the main page on anthem.com/ca to log in and search for a doctor, or call the Member Services number on your ID card. Members can call the number on the back of their identification card to confirm coverage. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. They are for people who have no symptoms of COVID-19 and no known or suspected exposure to people who have COVID-19. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. The most common early symptoms appear between 2 and 14 days after being infected. endstream endobj startxref As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. To learn where you can obtain a test visit the State of New Jerseys. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. border-radius: 50%; Members can call the Pharmacy Member Services number on their health plan ID card to learn more. Please log in and update your communication preferences to make sure you receive the latest information. COVID-19 screening related tests (e.g., influenza tests, blood tests, etc.) What codes would be appropriate for COVID-19 lab testing? Members will pay no deductible, copay or coinsurance for services ranging from doctors visits to hospital stays when their testing or treatment is related to COVID-19. From March 17, 2020, through September 30, 2020, Anthems affiliated health plans waived member cost shares for telehealth visits for services not related to the treatment of COVID-19 from in-network providers, including visits for behavioral health, for insured health plans in Colorado under this guidance, including our fully-insured employer plans, individual plans and health savings account-qualified high deductible health plans (HSA-HDHPs). O|bW7{}OH>d_O }N]1W#oFPt#Qg: zM/_5+kL#w9>!:Oy}QqywW}?7yAy}<7G4b0HR=DY7p#K7mw.p'E++PJ"1%uOt_{;t:GU/6q 7+n[Vg tTsk9EEML2`S2UJbpzGoKQ""J_/RkGx\&!^xY?Ej Vf!Yf \GE,w y-sML5/792d.6NL-8zRT-]B[t-Z9zMK.% 5zOeGOOZ.5,f.kvVdQ[ehY0$h Cant reach your doctor? Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Can I visit the emergency room for a test? The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. What you need to know about the disease and our coverage commitment. From March 19, 2020, through January 11, 2023, Anthem will cover and waive cost shares for telephonic-only visits with in-network providers for our Medicare Advantage plans. COVID-19 testing and visits associated with COVID-19 testing. Wash your hands often with soap and water for at least 20 seconds. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Serving residents and businesses in the 28 eastern and southeastern counties of New York State. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. Oct 13, 2022 Anthem will cover the administration of COVID-19 vaccines with no cost share for in- and out-of-network providers, during the national public health emergency, and providers are not permitted under the federal mandate to balance-bill members. 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. At-home test kits from Anthem: Are FDA-authorized. . Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. In addition, Anthem has established a team of experts to monitor, assess and help facilitate timely mitigation and response where we have influence as appropriate for the evolving novel coronavirus threat. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. Anthems enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthems Virtual Command Center for Emergency Management command, control and communication. Clean surfaces often, like countertops, doorknobs, light switches, faucets and more. Youve probably heard about coronavirus disease 2019 (COVID-19) and might be concerned. 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 members have access to telehealth 24/7 through LiveHealth Online. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? 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. 2023 Blue Cross Blue Shield Association. 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. Prior authorization is not required for COVID-19 testing. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. 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. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. This is a great time to think about changing any prescription medicines you take on a regular basis from a 30-day supply. No. We're here to make sure you have the resources and care you need to keep yourself safe and well. 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. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. 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. Otenti said if someone has been near a person with COVID-19 within a two-week time frame, there is also good reason to test for the virus . 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. Get the latest information on the COVID-19 vaccines. For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. Page one is in English and page two is in Spanish for each flyer. Do a video or phone visit with a doctor or therapist from home. Check the. Tell them if youve been in close contact with a person who has COVID-19, or if you live in or have been to an area where the virus has spread. Call our 24/7 Nurse Line for COVID-related health questions and advice. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. 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. padding: 0.6rem; What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. This applies to all members, regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for COVID-19 vaccination. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. Anthem will cover telephonic-only medical and behavioral health services from in-network providers and out-of-network providers when required by state law. Confusion; bluish lips or face; or unconsciousness. On December 18, 2020, the FDA also approved the Moderna vaccine for EUA for individuals aged 18 years and older. What diagnosis codes would be appropriate to consider for a patient with known or suspected COVID-19 for services where a members cost shares are waived? Do you have medicines you take regularly? Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Call the Pharmacy Member Services number on your ID card to find out about your options. Some Anthem health plans include LiveHealth Online. You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. The health of our members is always our top priority. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. If an in-network provider is not reasonably available, the cost share waivers will include testing or screening for COVID-19 when received from an out-of-network provider. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. Avoid close contact with people who are sick. Similar to a cold or the flu. 0 Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. Members can get their test covered at an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room. LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. If you are not, please use our Test Site Finder to learn about options near you. 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. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? Visit the CDC website for the most up-to-date testing guidance. 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