Fax medical prior authorization request forms to: 844-864-7853 It clarifies a utilization management vendor change for specific members. BCBS FEP Vision covers frames, lenses, and eye exams. rationale behind certain code pairs in the database. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Decide on what kind of signature to create. 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. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Medicare Advantage. Under the "Manuals" heading, click on the blue "Behavioral Health Provider Manual" text. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. FEP Medications requiring online prior authorization, Intravenous Immune Globulin (IVIG) Therapy, Stereotactic Radiosurgery Using Gamma Rays, Surprise Billing - Out-Of-Network Provider Notice, Ambulance -elective air transport only (10.0.005), Behavioral Health and Substance Use Disorder (Milliman Care Guidelines), Repetitive Transcranial Magnetic Stimulation (TMS), Inpatient Behavioral Health and Substance Use Disorder, Home health care (Criteria defined in the employer group benefit contract), Home Infusion Therapy (Criteria defined in the employer group benefit contract), Hospice (Criteria defined in the employer group benefit contract), Inpatient rehabilitation (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care), Maternity Services- inpatient only, for stay greater than 48/96 hours (Criteria defined in the employer group benefit contract), Out-of-network services (Benefits available according to the member contract), Private Duty Nursing (Criteria defined in the employer group benefit contract), Skilled nursing facility admissions (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care). hb``` ce`a`Y5 bR;)/}ksN}J^dcZ9@ @Hw400P`a Pl fKU0 e`c cpIqc1$frf3Hf6S\k{3*0ue`dzAyF ~ H00#9 L Select Auth/Referral Inquiry or Authorizations. 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. 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. Commercial Prior Authorization Summary and Code Lists Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. For your convenience, we've put these commonly used documents together in one place. This tool is for outpatient services only. Drug list/Formulary inclusion does not infer a drug is a covered benefit. In Ohio: Community Insurance Company. From cleanings to crowns, BCBS FEP Dental coverage options are available for federal employees, retirees, and eligible retired uniformed service members. Effective 01/01/2023 (includes changes effective 04/01/2023) . Inpatient Clinical: 800-416-9195. Create your signature and click Ok. Press Done. You can use the PriorAuthorizationLookupTool or reference the provider manual to determine if authorization is needed. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Plans for federal employees, retirees, retired uniformed service members, and active duty family members. This approval process is called prior authorization. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (in other words, experimental procedures, cosmetic surgery, etc. These documents contain information about your benefits, network and coverage. In Kentucky: Anthem Health Plans of Kentucky, Inc. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. 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). Scroll down to the table of contents. Type at least three letters and well start finding suggestions for you. Details about new programs and changes to our procedures and guidelines. This step will help you determine if prior authorization may be required for a specific member and service. Please refer to the criteria listed below for genetic testing. %PDF-1.6 % Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. Access the BH Provider Manuals, Rates and Resources webpage here. Effective 01/01/2022 - 09/17/2022; Prior Authorization Procedure Codes List for ASO Plans. Sign up to receive personalized communication from us, and we'll refine it to meet your preferences. Information about benefits for your patients covered by the BlueCard program. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. endstream endobj startxref 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. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. CareFirst reserves the right to change this list at any time without notice. Drug list/Formulary inclusion does not infer a drug is a covered benefit. As your health needs evolve, our diverse plans are designed to evolve with you. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists Long-Term Care (LTC) Forms. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Anthem HealthKeepers Plus Provider Manual, Long-term Services and Supports Authorization Guide. 451 0 obj <> endobj Do not sell or share my personal information. In Indiana: Anthem Insurance Companies, Inc. February 2023 Anthem Provider News - Missouri, New ID cards for Anthem Blue Cross and Blue Shield members - Missouri, Telephonic-only care allowance extended through April 11, 2023 - Missouri, January 2023 Anthem Provider News - Missouri, December 2022 Anthem Provider News - Missouri, November 2021 Anthem Provider News - Missouri. The clinical editing rationale supporting this database is provided here to assist you in understanding the 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. (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. Prior Authorization (Nonpharmacy) Provider Correspondence Forms. Nov 1, 2021 Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage applicable on the date services were rendered. 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. Mar 1, 2022 Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX. This approval process is called prior authorization. . Independent licensees of the Blue Cross and Blue Shield Association. Forms and information about behavioral health services for your patients. The list below includes specific equipment, services, drugs, and procedures requiring review and/or supplemental documentation prior to . Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. The latest edition and archives of our monthly provider newsletter. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. An Anthem (Blue Cross Blue Shield) prior authorization form is what physicians will use when requesting payment for a patient's prescription cost. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Code pairs reported here are updated quarterly based on the following schedule. Medical Injectable Drugs: 833-581-1861. We look forward to working with you to provide quality service for our members. 711. Please reference the Blues & CDHP Products Prior Authorization List on the Prior Authorization webpage. 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. Medical Clearance Forms and Certifications of Medical Necessity. Forms and information to help you request prior authorization or file an appeal. We encourage providers to use Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). * Once logged in to Availity at http://availity.com, select Patient Registration > Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry, as appropriate. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Follow the step-by-step instructions below to design your anthem forms: Select the document you want to sign and click Upload. We look forward to working with you to provide quality services to our members. endstream endobj 452 0 obj <. The Blue Cross name and symbol are registered marks of the Blue Cross Association. ). In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. You'll also find news and updates for all lines of business. With three rich options to choose from, weve got you covered. Select Patient Registration from the top navigation. To view the medical policies associated with each service, click the link or search for the policy number in the Medical Policy Reference Manual. Please use the Use the Prior Authorization tool within Availity, or Contact Provider Services To submit a precertification request: Log in to Availity. Start by choosing your patient's network listed below. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications Contact 866-773-2884 for authorization regarding treatment. The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. * Services may be listed as requiring precertification (prior authorization) that may not be covered benefits for a particular member. This list may vary based on account contracts and should be verified by contacting 1-866-773-2884. Anthems PriorAuthorizationLookupToolOnlinecan assist with determining a codes prior authorization requirements. 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. Provider Enrollment Forms. Anthem offers great healthcare options for federal employees and their families. Independent licensees of the Blue Cross Association. 2022 Standard Pre-certification list . One option is Adobe Reader which has a built-in reader. For more information, please refer to the Medical Policy Reference Manual. Noncompliance with new requirements may result in denied claims. In Connecticut: Anthem Health Plans, Inc. In Maine: Anthem Health Plans of Maine, Inc. 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. Independent licensees of the Blue Cross and Blue Shield Association. 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. PA requirements are available to contracted providers on the provider websiteat Medicare Advantage Providers | Anthem.com > Login or by accessing Availity. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. A follow-up article with additional information on transition of member care was posted Dec. 4, 2020. 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. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. Providers should call the prior authorization number on the back of the member ID card. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. (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 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. U.S. Department of Health & Human Services, National Association of Insurance Commissioners, Medicare Complaints, Grievances & Appeals. There are three variants; a typed, drawn or uploaded signature. You may also view the prior approval information in the Service Benefit Plan Brochures. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. 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). CareFirst does not guarantee that this list is complete or current. A prior approval is required for the procedures listed below for both the FEP Standard and Basic Option plan and the FEP Blue Focus plan. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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. Medicare Coverage with Anthem Medicare Information Medicare Coverage and Enrollment Turning 65 Medicare Advantage Plans: Part C Medicare Part D Plans Medicare Supplement Plans (Medigap) Dental and Vision Coverage CareCare What to Know Getting Better Care Preventive Health Find Care Medicare Caregiver Resources SupportSupport Login Registration 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. The prior authorization information in this notice does not apply to requests for HMO members. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Some procedures may also receive instant approval. The purpose of this communication is the solicitation of insurance. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Use of the Anthem websites constitutes your agreement with our Terms of Use. Most PDF readers are a free download. Please verify benefit coverage prior to rendering services. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. To learn more about required Colorado timelines for decisions regarding PA requests, please click, The Colorado Prescription Drug Prior Authorization Request form, The New Hampshire Prescription Drug Uniform Prior Authorization Request Form. 494 0 obj <>stream Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. 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