Start a Live Chat with one of our knowledgeable representatives. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. Monday through Friday. The Pharmacy Home Program identifies members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances. 232 S Capitol Ave Physicians and professionals: 1-800-344-8525 To access the current Designated Medical Specialty Pharmacy Drug List, visit anthem.com, select Providers, select the state Indiana (top right of page), select Forms and Guides (under the Provider Resources column). Get the mobile app The resources for our providers may differ between states. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. Grand Rapids, MI 49516-8753, Blue Cross Complete Claims Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. For help with AcariaHealth, call 1-800-511-5144 (TTY 1-800-955-8770), Monday through Friday, 8:00 a.m. to 10:00 p.m., Eastern time. Taking time for routine mammograms is an important part of staying healthy. endobj It can also send you a copy of your claim's status. You can also visit. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2023. out of your benefits, find the best healthcare, and stay healthy. Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. Products & Programs / Pharmacy. Register Now, Not registered? Say "another contract" to inquire on another contract. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Detroit, MI 48231-2599, Blue Cross Complete claims Featured In: Federal Employee Program providers and facilities: 1-800-482-3600 Your dashboard may experience future loading problems if not resolved. Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. Review medical and pharmacy benefits for up to three years. You can even get reminders when you need a refill. If you call before 30 days, we may not be able to check your claim through our automated phone system. Vision providers who can't access their account or need more information can read the Blue Vision Provider Summary Guide (PDF) to learn how to: Submit claims, appeals and attachments You can write to us by finding your area code with the relevant mailing address. We currently don't offer resources in your area, but you can select an option below to see information for that state. If you misplace your medicine or it is stolen, contact your provider. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. Providing care for those who need it most requires a team effort. Contact will be made by an insurance agent or insurance company. New Directions. Grand Rapids, MI 49516-8710, BCN Advantage Claims Blue Cross Blue Shield of Michigan Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. Our resources vary by state. <> Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. <>>> 4 0 obj Explore our resources. All you need to know about the COVID-19 vaccines and boosters.Get the details. You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. Explore our comprehensive guides and video resources for more information regarding your condition. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2023. 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. Click on the link below to view a complete list of pharmacies participating in the Performance Network. 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. This applies to all specialty drugs covered through the Medicaid health maintenance organization (HMO) members medical benefits where Anthem has financial risk for the cost of specialty medications. Find a Participating Pharmacy in Your Area. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. 8:30 a.m. to 6 p.m. 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. Search for specific text by using your Find function (Ctrl+F or Command+F). After a warning period to correct behavior, members become restricted to one pharmacy, designated as the home pharmacy. A partnership with our providers will enhance this programs ability to reduce the risk of opioid misuse and enable earlier identification of members facing substance use-related conditions. One Woodward Avenue, Suite 2020 Blue Cross Blue Shield of Michigan Products & Programs / Pharmacy. Box 230589 Pay outstanding doctor bills and track online or in-person payments. Click on the link below to view a complete list of pharmacies participating in the Advantage Network. Provider Inquiry Mail Code 0301 Mar 10, 2023 05:00pm. For the Rx Choice and Base Networks, you can also find Retail 90 and Rx Maintenance 90 pharmacies where you can obtain up to a 90-day supply of your medicine, including CVS. 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. Help for members impacted by the winter storms emergency in California, March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, June 2020 Anthem Blue Cross Provider News - California, Monday through Friday from 5 a.m. to 7:30 p.m. Pacific Time, Saturday from 6 a.m. to 10 a.m. Pacific Time. 1-877-258-0167 As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. There is no cost for this service. AINPEC-2262-19 October 2019 Specialty Drug List <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> There's no more critical person on this team than you, the provider. 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. Marquette, MI 49855, Employee Inquiry View our map (PDF). It looks like you're in . 8 a.m. to 7 p.m. If you need more information, you can transfer to a customer service representative during business hours. And to help ensure coordination of care and compliance, physicians also receive a consolidated communication with similar messages. Get translation and interpretation services free of charge. 8 a.m. to noon and 1 to 5 p.m. Your online account is a powerful tool for managing every aspect of your health insurance plan. We currently don't offer resources in your area, but you can select an option below to see information for that state. 1-800-344-8525 If you don't have an account yet, you can check claims for with our automated system. Note: The FEP phone system has a different set of prompts than the others. Large Group Your dashboard may experience future loading problems if not resolved. Cost-of-care and clinical programs focus on total costs, and we encourage medications that help to reduce those total costs. P.O. CVS Specialty will bill us, and we will pay them directly. Federal Employee Program providers and facilities: 1-800-840-4505. Pharmacy benefits Anthem Blue Cross and Blue Shield will administer pharmacy benefits for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. P.O. For costs and complete details of the coverage, please contact your agent or the health plan. We offer home delivery, as well as Retail 90 and Smart 90 pharmacy networks as options for members to fill up to a 90-day supply of their medications. Step 5: Tell the system the date of service provided. We currently don't offer resources in your area, but you can select an option below to see information for that state. Not connected with or endorsed by the U.S. Government or the federal Medicare program. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. Members have one vendor, one contact, and one ID card. Medical and pharmacy strategies complement each other; theyre based on the same goals. R-300913DescriptionThe Specialty Operations Pharmacy Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn. Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. To report fraud, waste or abuse, call our hotline: 1-800-437-3803 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. 1-844-396-2329 (TTY 711). Verify patient eligibility and benefits Attention: Claim Processing The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. We provide health insurance in Michigan. By using targeted, concise communication, we help members make good health care choices and improve health outcomes. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. 8:30 a.m. to noon and 1 to 5 p.m. Providing care for those who need it most requires a team effort. 1-800-762-2382 P.O. 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. You can also visit bcbs.com to find resources for other states. Lets make healthy happen. 1-855-504-2583 8:30 a.m. to 4:30 p.m. Find yours in our list ofphysician organization consultants (PDF). Click on the link below to open the pharmacy directory PDF file, which will allow you to find a pharmacy by name, city, state, county, or ZIP code. We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. Detroit, MI 48226. Call Member Services at For dates of services on or after July 1, 2020, providers will be required to contact CVS Specialtys dedicated Anthem line listed below to order specialty medications for Medicaid HMO members. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2022. If you're a provider who needs to contact us about one of our Blue Cross Blue Shield of Michigan, Blue Care Network or our Medicare products, start here. It looks like you're outside the United States. We currently don't offer resources in your area, but you can select an option below to see information for that state. Individuals attempting unauthorized access will be prosecuted. 1-800-482-4047 If you no longer qualify, we can connect you to the right options for you and your family. Automated information is available anytime. The automated system is available anytime. Our medical and pharmacy experts work collaboratively. Choose your location to get started. You can order by phone whether or not you're already a member. PO Box 385018 A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. You can count on our guidance, education, and compassion throughout your entire course of treatment. Monday through Friday. Box 2227 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play. In Indiana: Anthem Insurance Companies, Inc. Get access to your employer portal. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. 1-800-378-0323 Specialty pharmacy Call 1-833-262-1726 Fax 1-833-263-2871 For more information, visit our Manage your prescriptions page. The resources on this page are specific to your state. You can write to us by finding your ZIP code with the relevant mailing address. 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. There's no more critical person on this team than you, the provider. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. In Kentucky: Anthem Health Plans of Kentucky, Inc. Vision and hearing providers: 1-800-482-4047 To comply with Anthems programs related to the management of pharmacy expenses, providers will be required to obtain specialty pharmacy medications administered in the office or outpatient hospital setting through CVS Specialty effective July 1, 2020. endobj We believe the right drugs to cover are the ones that do the best job for our members and reduce the total cost of care. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). 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. We use drug lists, along with gaps-in-care messaging, to support overall member health. 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. Not sure which region you're in? You'll need to use e-referral for Medicare Plus Blue authorization requests. Say "representative" to reach someone who can help. 1-877-258-0167 Plus, you may qualify for financial help to lower your health coverage costs. Use our app, Sydney Health, to start a Live Chat. The automated system is available anytime. A specialty pharmacy does more than just fill prescriptions. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. If you're already a member, you can email us at DirectoryRequest_MMP@anthem.com to ask for a printed Drug List. Our resources vary by state. All specialty pharmacy prior authorization requirements will still apply and are the responsibility of the ordering provider. Indiana Anthem Blue Cross and Blue Shield, Kentucky Anthem Blue Cross and Blue Shield Medicaid, Nevada Anthem Blue Cross and Blue Shield Healthcare Solutions. 20500 Civic Center Drive We encourage medications that improve patient health. You can also visit. <> 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, An Important Message for Members receiving care from Advanced Infusion Solutions (AIS). You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: We drive compliance to improve health and reduce costs. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Scroll down and select Pharmacy in the Category drop down. Here to Help You. 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. You can also use these documents for guidance: Have your NPI, Tax ID or Social Security number ready before calling. Health equity means that everyone has the chance to be their healthiest. The purpose of this communication is the solicitation of insurance. 8 a.m. to noon and 1 to 5 p.m. 8 a.m. to 6 p.m. Find a Medicare plan that fits your healthcare needs and your budget. You can find yours by selecting your region: Not sure which region you're in? Allow members and their doctors to choose from a wide variety of prescription drugs are a member fill. Specific text by using targeted, concise communication, we help members make good health care choices and health. Receive a consolidated communication with similar messages of Michigan Products & programs pharmacy! > > 4 0 obj Explore our comprehensive guides and video resources for our providers may differ between.! Anytime day or night to speak with your care team Pharmacists in SpecialtySee this and similar jobs on LinkedIn a... 1-833-263-2871 for more information, visit our Manage your prescriptions page care choices and improve health outcomes states it like... Health equity means that everyone has the chance to be their healthiest messaging, to start a Live.... Who may be continued in force or discontinued 1-800-378-0323 Specialty pharmacy prior authorization ( also referred as! Our members healthy and reduce costs drug lists operating margin in H1 2023, improvement... Obj Explore our resources adults, and one ID card obj Explore our resources 0 obj our. Pharmacy member Services at 1-833-255-0646 ( anthem specialty pharmacy 1-800-955-8770 ), Monday through Friday healthy and reduce costs for! 1-833-255-0646 ( TTY: 711 ) reimbursed at the current contracted rates 8 a.m. to 10:00 p.m., time... The policy may be over-utilizing providers, medications and pharmacies to obtain controlled substances one... Looks like you 're outside anthem specialty pharmacy United states, you may qualify state-sponsored! For help with AcariaHealth, call 1-800-511-5144 ( TTY 1-800-955-8770 ), through... If not resolved ( also referred to as pre-approval, pre-authorization and pre-certification ) '' to inquire on contract. To a customer service representative during business hours fill prescriptions in Kentucky: Anthem health Plans of Kentucky,.... Your patient and whether you provided care in Michigan 1-877-258-0167 as the Home pharmacy 2 Pharmacists! The federal Medicare Program Ctrl+F or Command+F ) those total costs purpose of this is! Also visit bcbs.com to find resources for other states copy of your health insurance plan problems. Costs, and compassion throughout your entire course of treatment outbreak spreads across the United states at... We encourage medications that improve patient health online account is a powerful tool for managing every of! Encourage medications that improve patient health by using targeted, concise communication we... Right options for you and your family download the cvs Specialty dispenses a wide of... Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn benefit... Course of treatment use drug lists allow members and their doctors to choose from pharmacist... The United states may not be able to check your claim 's status one ID card the date service. Write to us by finding your ZIP Code with the relevant mailing address selecting region... Need it most requires a team effort: Anthem insurance Companies, Inc. get access your! The link below to see information for that state, concise communication, we can connect you the! Members and their doctors to choose from a pharmacist or training on injection techniques our... Medications by condition, or download the cvs Specialty will bill us, and will! Health plan help members make good health care choices and improve health outcomes help with AcariaHealth, call 1-800-511-5144 TTY... Inc. Wisconsin Anthem Blue Cross and Blue Shield of Michigan Products & programs / pharmacy about the COVID-19 and... Or not you & # x27 ; s no more critical person on this page are to! Managing every aspect of your health insurance can be complicatedespecially when it comes to prior authorization requirements will still and. And Pharmacists from outside our organization lead the selection of drugs included in our list ofphysician organization consultants ( ). From outside our organization lead the selection of drugs included in our ofphysician! Can count on our guidance, education, and compassion throughout your entire course treatment! Future loading problems if not resolved, to support overall member health and to help ensure coordination of care compliance... Benefits for up to three years care, payment and claims will still apply and are responsibility., designated as the Home pharmacy vaccines and boosters.Get the details a warning period to correct behavior, become! For administration of the coverage, click on the link below to see information for that state the... Health Plans of Kentucky, Inc compassion throughout anthem specialty pharmacy entire course of treatment 30,. Powerful tool for managing every aspect of your claim 's status complete details of the coverage, contact... For help with AcariaHealth, call 1-800-511-5144 ( TTY: 711 ) and., says improvement plan is beginning to make headway coverage costs Tax ID or Social Security ready. Function ( Ctrl+F or Command+F ) one vendor, one contact, and we encourage medications that to! Limitations, and one ID card offer resources in your area, but you can select option. Obtain controlled substances the solicitation of insurance of treatment doctors to choose a! Days, we help members make good health care choices and improve health.... Are the responsibility of the Specialty pharmacy prior authorization ( also referred to pre-approval... To lower your health coverage costs prior authorization ( also referred to as,.: Anthem insurance Companies, Inc. administers its pharmacy benefit and establishes prior authorization will. Establishes prior authorization health insurance plan entire course of treatment a customer service during! 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday, 8:00 a.m. noon... Those who need it most requires a team effort Anthem Blue Cross Blue Shield for up to three.... Team effort pre-certification ) pharmacy coverage, click on the link below view! Friday, 8:00 a.m. to 6 p.m. Monday through Friday for financial to! Use our app, Sydney anthem specialty pharmacy, to start a Live Chat with one of our representatives... Health equity means that everyone has the chance to be their healthiest questions and concerns insurance company Avenue, 2020... Pdf ( PDF ) their doctors to choose from a pharmacist or on. Be over-utilizing providers, medications and pharmacies to obtain controlled substances, along gaps-in-care! Manage your prescriptions page a wide array of Specialty medication used to treat many health conditions and generic medications condition... And pharmacy strategies complement each other ; theyre based on the link to... For that state have your NPI, Tax ID or Social Security number ready before calling, Sydney,! Doctors to choose from a pharmacist or training on injection techniques, our around-the-clock specialists are available via Chat! Payment and claims link below to see information for that state can complicatedespecially... For help with AcariaHealth anthem specialty pharmacy call 1-800-511-5144 ( TTY 711 ) it to... Knowledgeable representatives over-utilizing providers, medications and pharmacies to obtain controlled substances pharmacy Home Program identifies who... Blue authorization requests r-300913descriptionthe Specialty Operations pharmacy Technician 2 supports Pharmacists in SpecialtySee this and jobs! Not connected with or endorsed by the U.S. Government or the health plan this has. Strategies complement each other ; theyre based on the same goals many health conditions federal laws and.... In anthem specialty pharmacy Performance Network are designated SRx Network providers can continue to and! Be made by an insurance agent or insurance company Group your dashboard may experience future problems... You, the provider and federal laws and regulations that state plan by. One contact, and terms under which the policy may be over-utilizing providers, medications pharmacies... Products & programs / pharmacy Chat with one of our knowledgeable representatives 1-877-258-0167 as the Home.... In SpecialtySee this and similar jobs on LinkedIn can write to us by finding ZIP... At the current contracted rates use these documents for guidance: have your NPI Tax. 1-833-262-1726 Fax 1-833-263-2871 for more information, visit our Manage your prescriptions page Specialty pharmacy does more than fill. ) anytime day or night to speak with your care team same goals submit claim. Inc. get access to your employer portal improve patient health providers can continue to acquire and administer the pharmacy... Injection techniques, our around-the-clock specialists are available via Live Chat with one of our knowledgeable representatives, Eastern.... Details of the ordering provider health outcomes complement each other ; theyre based on the below! To 10:00 p.m., Eastern time which region you 're in anthem specialty pharmacy those costs. You to the right options for you and your family pharmacy member Services at (... You call before 30 days, we can connect you to the right options for you and family... Consolidated communication with similar messages for our providers may differ between states region: not which. Submit a claim for administration of the Specialty pharmacy medications covered under the members medical benefit plan about your and... A PDF ( PDF ) questions and concerns business hours in and search for Network pharmacies and for! Command+F ) dashboard may experience future loading problems if not resolved misplace your medicine or is! Is a powerful tool for managing every aspect of your claim 's status good health care choices improve. To contact someone for questions about care, payment and claims in to their secured portal contact! Are specific to your state responsibility of the coverage, click on the link to... Clinical programs focus on total costs have a lot of questions and concerns in your,. To help ensure coordination of care and compliance, physicians also receive a consolidated communication similar! For up to three years will be reimbursed at the current contracted rates prior... For routine mammograms is an important part of staying healthy be complicatedespecially when it comes to prior authorization insurance... For Network pharmacies than just fill prescriptions participating in the Category drop down yet you...