Select Patient Registration from the top navigation. Commercial non-HMO prior authorization requests can be submitted to AIM in two ways. View the list of services below and click on the links to access the criteria used for Pre-Service Review decisions. Anthem Blue Cross and Blue Shield (Anthem) recommends submitting precertification requests via Interactive Care Reviewer (ICR), a secure utilization management tool available in Availity. Mar 1, 2022 Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. U.S. Department of Health & Human Services, National Association of Insurance Commissioners, Medicare Complaints, Grievances & Appeals. Forms and information about pharmacy services and prescriptions for your patients. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. 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. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. Contracted and noncontracted providers who are unable to access Availity may call the number on the back of the members ID card. To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Information about benefits for your patients covered by the BlueCard program. 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 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. Under the "Manuals" heading, click on the blue "Behavioral Health Provider Manual" text. Contact 866-773-2884 for authorization regarding treatment. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). One option is Adobe Reader which has a built-in reader. Providers should continue to verify member eligibility and benefits prior to rendering services. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Choose My Signature. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. 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. Prior Authorization (Nonpharmacy) Provider Correspondence Forms. Prior authorization list. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). %%EOF Details about new programs and changes to our procedures and guidelines. This list contains notification/prior authorization requirements for inpatient and outpatient services. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Future updates regarding COVID-19 will appear in the monthly Provider News publication. 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. 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 Do not sell or share my personal information. Medical Clearance Forms and Certifications of Medical Necessity. There are three variants; a typed, drawn or uploaded signature. HealthKeepers, Inc. recommends submitting prior authorization requests for Anthem HealthKeepers Plus members via Interactive Care Reviewer (ICR), a secure Utilization Management tool available in Availity. Type at least three letters and well start finding suggestions for you. Pharmacy Forms. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. Summaries and code lists are posted as a reference to help you determine when prior authorization may be required for non-HMO government programs members. Follow the step-by-step instructions below to design your anthem forms: Select the document you want to sign and click Upload. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). To view this file, you may need to install a PDF reader program. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. Customer Care Center hours are Monday to Friday 7 a.m. to 7 p.m. After hours, verify member eligibility by calling the 24/7 NurseLine at. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. 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. 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. Code Bundling Rationale 2017 Q3 CPT Codes, Code Bundling Rationale 2017 Q2CPT Codes, Code Bundling Rationale 2017 Q1CPT Codes, Code Bundling Rationale 2016 Q4CPT Codes, Code Bundling Rationale 2016 Q3CPT Codes, Code Bundling Rationale 2016 Q2CPT Codes, Code Bundling Rationale 2016 Q1CPT Codes, Code Bundling Rationale 2015 Q4CPT Codes, Code Bundling Rationale 2015 Q3CPT Codes, Code Bundling Rationale 2015 Q2CPT Codes, Code Bundling Rationale 2015 Q1CPT Codes, Code Bundling Rationale 2014 Q4CPT Codes, Code Bundling Rationale 2014 Q3CPT Codes, Code Bundling Rationale 2014 Q2CPT Codes, Code Bundling Rationale 2014 Q1CPT Codes, Code Bundling Rationale 2013 Q4CPT Codes, Code Bundling Rationale 2013 Q3CPT Codes, Code Bundling Rationale 2013 Q2CPT Codes, Code Bundling Rationale 2013 Q1CPT Codes, Code Bundling Rationale 2012 Q4CPT Codes, Code Bundling Rationale 2012 Q3CPT Codes, Code Bundling Rationale 2012 Q2CPT Codes, Code Bundling Rationale 2012 Q1CPT Codes, Code Bundling Rationale 2011 Q4CPT Codes, Code Bundling Rationale 2011 Q3CPT Codes, Code Bundling Rationale 2011 Q2CPT Codes, Code Bundling Rationale 2011 Q1CPT Codes, Code Bundling Rationale 2010 Q4CPT Codes, Code Bundling Rationale 2010 Q3CPT Codes, Code Bundling Rationale 2010 Q2CPT Codes, Code Bundling Rationale 2010 Q1CPT Codes, 1998-document.write(new Date().getFullYear()); BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. 1 Cameron Hill Circle, Chattanooga TN 37402-0001, Change of Ownership and Provider ID Number Change Information. In Ohio: Community Insurance Company. For your convenience, we've put these commonly used documents together in one place. The latest edition and archives of our monthly provider newsletter. Not connected with or endorsed by the U.S. Government or the federal Medicare program. With three rich options to choose from, weve got you covered. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. 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. hbbd```b``+d3d] fIM|0+d:"Y`XM7`D2HO H2Xb R?H?G _q Large Group 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. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. You may also view the prior approval information in the Service Benefit Plan Brochures. Please reference the Blues & CDHP Products Prior Authorization List on the Prior Authorization webpage. COVID-19 Information - New Hampshire - Publication RETIRED as of November 8, 2022. This tool is for outpatient services only. 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. Call our Customer Service number, (TTY: 711). 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. Note: Blue High Performance NetworkSM (BlueHPNSM) members have limited benefits at the University of Maryland Medical System Downtown Campus. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. Code pairs reported here are updated quarterly based on the following schedule. For more information, please refer to the Medical Policy Reference Manual. rationale behind certain code pairs in the database. 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 Independent licensees of the Blue Cross Association. Start by choosing your patient's network listed below. 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 National Accounts, Posts about using health Insurance and managing your health, Collections of learning resources and links to services, For Sydney Health users connect with others and find care programs. Provider Enrollment Forms. Here youll find information on the available plans and their benefits. * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. 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. Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022. These manuals are your source for important information about our policies and procedures. February 2023 Anthem Provider News - Virginia, New ID cards for Anthem Blue Cross and Blue Shield members - Virginia, Telephonic-only care allowance extended through April 11, 2023 - Virginia, January 2023 Anthem Provider News - Virginia, December 2022 Anthem Provider News - Virginia, Medicare Advantage Providers | Anthem.com, March 2022 Anthem Provider News - Virginia, K1022 Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type. Anthem offers great healthcare options for federal employees and their families. Access eligibility and benefits information on the Availity Web Portal or Use the Prior Authorization Lookup Tool within Availity or Contact the Customer Care Center: Outside Los Angeles County: 1-800-407-4627 Inside Los Angeles County: 1-888-285-7801 Customer Care Center hours are Monday to Friday 7 a.m. to 7 p.m. Drug list/Formulary inclusion does not infer a drug is a covered benefit. Anthems PriorAuthorizationLookupToolOnlinecan assist with determining a codes prior authorization requirements. (Note: For changes to come later this year, refer to this notice, posted Dec. 28, 2020: Commercial Prior Authorization Code Changes, Effective April 1, 2021. Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Please check your schedule of benefits for coverage information. Anthem does not require prior authorization for treatment of emergency medical conditions. Forms and information to help you request prior authorization or file an appeal. 2022 Standard Pre-certification list . PPO outpatient services do not require Pre-Service Review. Community Supports under CalAIM are voluntary wrap-around services or settings available to members as a substitute for utilization of other services that focus on medical and/or needs that arise from social determinants of health. If you have questions regarding the list, please contact the dedicated FEP Customer Service team at 800-532-1537. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. 451 0 obj <> endobj Independent licensees of the Blue Cross and Blue Shield Association. 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. Contact 866-773-2884 for authorization regarding treatment. 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. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). In Ohio: Community Insurance Company. You can also check status of an existing request and auto-authorize more than 40 common procedures. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Effective 01/01/2023 (includes changes effective 04/01/2023) . Plans for federal employees, retirees, retired uniformed service members, and active duty family members. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. 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). Drug list/Formulary inclusion does not infer a drug is a covered benefit. Please use the The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists hb``` ce`a`Y5 bR;)/}ksN}J^dcZ9@ @Hw400P`a Pl fKU0 e`c cpIqc1$frf3Hf6S\k{3*0ue`dzAyF ~ H00#9 L 711. Referencing the . 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). You'll also find news and updates for all lines of business. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. Third-Party Liability (TPL) Forms. 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. This new site may be offered by a vendor or an independent third party. Medical Injectable Drugs: 833-581-1861. ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. In Maine: Anthem Health Plans of Maine, Inc. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. In Indiana: Anthem Insurance Companies, Inc. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Please refer to the criteria listed below for genetic testing. Select Auth/Referral Inquiry or Authorizations. In 2020, Part B step therapy may apply to some categories . The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Or Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. Forms and information about behavioral health services for your patients. BlueCross BlueShield of Tennessee uses a clinical editing database. ) refer to your, Access eligibility and benefits information on the, Use the Prior Authorization Lookup Tool within Availity or. Providers should call the prior authorization number on the back of the member ID card. %PDF-1.6 % We look forward to working with you to provide quality services to our members. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Commercial Prior Authorization Summary and Code Lists ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. These documents contain information about your benefits, network and coverage. Home Employer Federal Employees Blue Cross And Blue Shield Service Benefit Plans Medical Plans Create your signature and click Ok. Press Done. To view the medical policies associated with each service, click the link or search for the policy number in the Medical Policy Reference Manual. Part B Step Therapy (204 KB) Drug step therapy is a type of prior authorization that requires one drug (or drugs) to be tried for a medical condition prior to utilizing other drugs; the steps typically require lower cost drugs or drugs with better clinical outcomes to be tried first. An Anthem (Blue Cross Blue Shield) prior authorization form is what physicians will use when requesting payment for a patient's prescription cost. View this file, you may need to install a PDF reader program to categories! By choosing your Patient & # x27 ; ve put these commonly used documents together in one place complicatedespecially it! & # x27 ; ve put these commonly used documents together in one place your convenience we. Healthcare Plan of Georgia, Inc provided by such vendors, you may need install... 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