8:30 a.m. to 4:30 p.m. Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. Specialty Pharmacy Benefits | Anthem Blue Cross Blue Shield Nevada Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Connecticut: Anthem Health Plans, Inc. All you need to know about the COVID-19 vaccines and boosters.Get the details. The automated system is available anytime. Note: The FEP phone system has a different set of prompts than the others. You can count on our guidance, education, and compassion throughout your entire course of treatment. A specialty pharmacy does more than just fill prescriptions. * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. Just keep in mind you'll need to go through the prompts before you're connected to someone. Box 312599 Box 2227 Your online account is a powerful tool for managing every aspect of your health insurance plan. Independent licensees of the Blue Cross and Blue Shield Association. London, KY 40742. Box 230589 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. 1-877-258-0167 If you have Rx Maintenance 90 and use CVS, you can get a 90-day supply of any covered drug and pay your home delivery rate. 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. View listings below of the retail pharmacies that participate in our pharmacy networks. Southfield, MI 48075. Step 1: Say "claims" when the system asks why you're calling. Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). View our map (PDF). Monday through Friday Box 68753 Blue Care Network Drugs used for the treatment of Oncology will still require pre-service clinical review by AIM. Use of the Anthem websites constitutes your agreement with our Terms of Use. 8 a.m. to 4 p.m. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. Effective for dates of service March 1, 2022, and beyond, requests for the medications listed above and the clinical information submitted will be reviewed for both medical necessity of the medication itself (as is done endobj Click on the link below to view a complete list of pharmacies participating in the Advantage Network. Not registered? Not sure which region you're in? 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. With the Rx Choice Network, you can choose from two levels of coverage, helping to provide both savings and access: 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. Creating an account is free, easy and helps patients get their medications sooner. There are some things in life that we depend on. We've gathered resources and tools to help you work as efficiently and productively as possible and do what you do best- care for our members. You can write to us by finding your area code with the relevant mailing address. Call our Customer Service number, (TTY: 711). Medication is often one of them. CVS Specialty will bill us, and we will pay them directly. 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. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. The resources on this page are specific to your state. This applies to all Anthem Indiana commercial members. Your dashboard may experience future loading problems if not resolved. Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. The automated system is available anytime. The automated system is available anytime. Medical Prior Authorization requests can be submitted through CoverMyMeds. 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. IngenioRx Specialty Pharmacy provides your specialty medications. We've gathered resources and tools to help you work as efficiently and productively as possible and do what you do best- care for our members. Access your member ID card from our website or mobile app. You can write to us by finding your ZIP code with the relevant mailing address. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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). 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. If you need additional guidance, read the Dentaquest Dental Manual (PDF). Physicians and professionals: 1-800-344-8525 We provide health insurance in Michigan. P.O. Contact customer service, Heritage Provider service: 1-800-252-2053. A specialty pharmacy does more than just fill prescriptions. Specialty drug list Anthem Blue Cross and Blue Shield Healthcare Solutions is contracted with Accredo as our exclusive pharmacy supplier for high-cost, specialty/injectable drugs that treat a number of chronic or rare conditions. CVS Specialty Pharmacy is an Anthem Blue Cross (Anthem) designated provider of certain specialty medications administered in the office or outpatient hospital setting. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. 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. 1-800-822-2761 If you're interested in joining the Physician Group Incentive Program, also known as PGIP, or want more information, emailvaluepartnerships@bcbsm.com. We offer affordable health, dental, and vision coverage to fit your budget. 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. 1 0 obj Federal Employee Program providers and facilities: 1-800-482-3600 Register Now, Learn more about registering for our web tools. Look for these symbols in the pharmacy listings: Pharmacy search tips: 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. The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. Specialty medications are used to treat these conditions and often require special storage or extra support. The resources for our providers may differ between states. Well take it from there. Providing care for those who need it most requires a team effort. Call Member Services at 232 S Capitol Ave Monday through Friday Choose your location to get started. 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. 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. Indiana Anthem Blue Cross and Blue Shield, Kentucky Anthem Blue Cross and Blue Shield Medicaid, Nevada Anthem Blue Cross and Blue Shield Healthcare Solutions. 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. Your browser is not supported. If you have any questions about your pharmacy benefits, call Pharmacy Member Services at 1-833-207-3120 (TTY 711) 24 hours a day, seven days a week. If specialty medications are obtained through other pharmacies, the claim will be denied. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. Level 2: For an extra copay or percentage of the drug cost (depending on your benefit), you have more choices with Level 2 pharmacies, no matter which drug you fill. 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. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. When you email us, we'll call . Monday through Friday. Jan 1, 2021 Step 2: Answer the prompts about your patient and whether you provided care in Michigan. 8 a.m. to 5 p.m. 1-800-482-4047 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. Attention: Claim Processing New member? If you misplace your medicine or it is stolen, contact your provider. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. Monday through Friday. Taking time for routine mammograms is an important part of staying healthy. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Scroll down and select Pharmacy in the Category drop down. We look at how drugs work in the real lives of our members, then use our medical and pharmacy data and analyze claims analysis to make sure the medications really work. Preferred Drug List and Formulary Search Detroit, MI 48231-0166, Federal Employee Program claims Providers who don't have an account can mail a claim to one of the following: Medicare Plus BlueSM PPO claims We also offer infusion services with Optum Infusion Pharmacy. P.O. Pay outstanding doctor bills and track online or in-person payments. CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. We currently don't offer resources in your area, but you can select an option below to see information for that state. You can use our automated system to reach a representative to discuss your claim's outcome. Just keep in mind you'll need to go through the prompts before you're connected to someone. Members should talk with their doctor about prescribing a drug that is on the drug list. Step 6:Tell the system the total amount charged. Use our app, Sydney Health, to start a Live Chat. When you're contracted with us you have access to a provider consultant. Once we identify a gap in care, the member receives a personalized Medication Review, which contains pharmacy messaging for our clinical and cost-of-care programs in one consolidated, health plan-branded, monthly member communication. Our goal is to help improve your patients' health outcomes by combining medical, pharmacy and lab data ensuring coordination of our people, programs and . If your state isn't listed, check out bcbs.com to find coverage in your area. Find answers to all your questions with an Anthem representative in real time. Monday through Friday. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. One Woodward Avenue, Suite 2020 As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. TTY users: To reach any number listed here, dial 711. R-300913DescriptionThe Specialty Operations Pharmacy Technician 2 supports Pharmacists in SpecialtySee this and similar jobs on LinkedIn. Blue Cross Blue Shield of Michigan 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. The purpose of this communication is the solicitation of insurance. Understand your care options ahead of time so you can save time and money. Step 5:Tell the system the date of service provided. Get help with your copays by chatting with a patient care coordinator today. Federal Employees Program Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. 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. You can even get reminders when you need a refill. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 a.m. to 8 p.m. ET/CT, 7 a.m. to 7 p.m. MT/PT. Policies are aligned. submittal. Vision and hearing providers: 1-800-482-4047 Quickly and easily submit out-of-network claims online. Monday through Friday, 1-800-431-1059 Step 4: Say "yes" when asked if you have additional questions about the determination of the claim. 8:30 a.m. to noon and 1 to 5 p.m. We encourage medications that improve patient health. 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. We promise to always deliver simple ways to get the medication you need. Not connected with or endorsed by the U.S. Government or the federal Medicare program. Price a medication, find a pharmacy,order auto refills, and more. For costs and complete details of the coverage, please contact your agent or the health plan. 20500 Civic Center Drive Say "another contract" to inquire on another contract. You purchased a plan on your state or federal Health Insurance Marketplace (also known as the exchange), You purchased coverage off the exchange and not through your employer, Your coverage is through a Small Group employer on, and in some cases, off the exchange. Blue Cross Blue Shield of Michigan Say "fax or email" to receive a copy of your claim's status. In Maine: Anthem Health Plans of Maine, Inc. endobj We are leading the health care industry in the way we choose covered drugs, analyzing the strongest clinical drug studies and member data to see how drugs are really working for patients. Monday through Friday. 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. Manage your medicine from anywhere with the Anthem mobile app With the free app, you can: Order refills Track orders View all prescriptions Download the app now: Page Last Updated: 06/09/21 If you have questions or need assistance, we're always here to help. Mar 10, 2023 05:00pm. 20500 Civic Center Drive 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. There is no cost for this service. Check ereferrals.bcbsm.com for detailed prior authorization information. Verify patient eligibility and benefits Call Pharmacy Member Services toll free at 1-833-370-7466 (TTY: 711) 24 hours a day, 7 days a week to ask us to mail you a Drug List. Find a Medicare plan that fits your healthcare needs and your budget. Grand Rapids, MI 49516-8753, Blue Cross Complete Claims Find out if your medication is available through CVS Specialty. In Indiana: Anthem Insurance Companies, Inc. endobj The Rx Choice Tiered Network may not be available in all states. Marquette, MI 49855, Employee Inquiry We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. We use Availity Essentials as our provider portal. Blue Vision providers submit claims electronically directly toVSP. 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