Important informationabout your 1095-B form. CVS Specialty makes living with your condition easier. 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. Box 230589 Contact will be made by an insurance agent or insurance company. Log in to your account to manage your specialty prescriptions. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. L07B Monday through Friday P.O. 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. Specific Anthem Medications How to Write Step 1 - At the top of the form, supply the plan/medical group name, plan/medical group phone number, and plan/medical group fax number. Your browser is not supported. 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. If you have questions or need assistance, we're always here to help. Providers should continue to submit for administration of the medication, but not bill for the medication itself. 1-844-876-7917 42I]?evMJz8q9|eszwdZL9}owq1}s&,/K{IP,xW^.` 8:30 a.m. to 4:30 p.m. 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. Specialty pharmacies have highly trained pharmacists and nurses to provide personal care and guidance to help you manage your condition. 8:30 a.m. to noon and 1 to 5 p.m. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Explore our comprehensive guides and video resources for more information regarding your condition. Use New Directions' WebPass tool. 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. Detroit, MI 48232-4248, Provider Inquiry We currently don't offer resources in your area, but you can select an option below to see information for that state. Physicians and professionals: 1-800-344-8525 % 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. 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. Please call Accredo at 1-844-433-4878 or visit Step 4: Say "no" when asked if you have additional questions about the determination of a claim. Not registered? 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. Facility and Special Programs 2005 - 2022 copyright of Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. Detroit, MI 48231-2599, Blue Cross Complete claims If youre an administrative office of a medical care group, you have access to a professional organization consultant. If you are interested in participating in the Designated SRx Network, please contact your provider contracting representative for more details. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. Box 312599 8 a.m. to 7 p.m. You can write to us by finding your area code with the relevant mailing address. P.O. In Indiana: Anthem Insurance Companies, Inc. Blue Cross Blue Shield of Michigan To report fraud, waste or abuse, call our hotline: 1-800-437-3803 From easy online refills to one-on-one CareTeam support from specially trained nurses and pharmacists, we give patients the care they need, when and where they need it. If you're notanEssential Vision provider, send claims to: Heritage Vision Plans, Inc. London, KY 40742. Our medical and pharmacy experts work collaboratively. A specialty pharmacy does more than just fill prescriptions. 8 a.m. to 7 p.m. Marquette, MI 49855, Employee Inquiry Blue Cross Blue Shield of Michigan Monday through Friday 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 Find a Participating Pharmacy in Your Area. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Please update your browser if the service fails to run our website. Monday through Friday We offer affordable health, dental, and vision coverage to fit your budget. Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. In Ohio: Community Insurance Company. 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. Lets make healthy happen. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. For a step-by-step guide to Electronic Data Interchange, also known as EDI, read our FAQ on the topic. There's no more critical person on this team than you, the provider. You can: Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime day or night to speak with your Care Team. It looks like you're outside the United States. The failure to do so may result in claim denials and the member cannot be billed for these specialty medications. Contact customer service, Heritage Provider service: 1-800-252-2053. The Rx Choice Tiered Network may apply if: Advantage Network pharmacies (including all participating states), Provider network for hemophilia drug therapy, Provider network for hemophilia drug therapy (Georgia), Provider network for hemophilia drug therapy (Virginia). Medical and pharmacy strategies complement each other; theyre based on the same goals. Get access to your online account.Register Now, Not registered? The purpose of this communication is the solicitation of insurance. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. Medicaid renewals are starting. 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. This group performs regular clinical reviews, rates drugs based on how they work in real life, evaluates drug costs to make sure they are affordable, and chooses drugs that are safe, work well and offer the best value. Our resources vary by state. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. Make your mental health a priority. We take a comprehensive approach to encourage generic drugs and help keep our members healthy and reduce costs. We currently don't offer resources in your area, but you can select an option below to see information for that state. Verify patient eligibility and benefits Register Now, Learn more about registering for our web tools. This applies to all Anthem Indiana commercial members. Preferred Drug List and Formulary Search Price a medication, find a pharmacy,order auto refills, and more. Pharmacy Information for Providers. We promise to always deliver simple ways to get the medication you need. Get the mobile app The automated system is available anytime. 8 a.m. to noon and 1 to 5 p.m. Find yours in our list ofphysician organization consultants (PDF). 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. You can even get reminders when you need a refill. As the monkeypox outbreak spreads across the United States, you may have a lot of questions and concerns. Learn more. Blue Care Network CVS Specialty will bill us, and we will pay them directly. Whether you need to check on a claim, pay a bill, or talk to a representative, you can easily access all your member features. Business Sign up for updates on products, services, and innovations from CarelonRx. P.O. Members dont receive multiple letters focused on individual clinical and cost-of-care programs. Health equity means that everyone has the chance to be their healthiest. Box 33248 Anthem Blue Cross and Blue Shield BadgerCare Plus and Medicaid SSI Programs Specialty pharmacy site of care Page 2 of 2 . Providers may continue to submit a claim for administration of the specialty pharmacy medications, which will be reimbursed at the current contracted rates. Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. There is no cost for this service. These pharmacies serve members with complex or chronic conditions. The Base Network is our national pharmacy network and includes nearly 70,000 retail pharmacies across the country. The resources on this page are specific to your state. 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. 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. When you're contracted with us you have access to a provider consultant. Find answers to all your questions with an Anthem representative in real time. Just keep in mind you'll need to go through the prompts before you're connected to someone. We see how drugs work in our members real lives and help them make good health care choices. Get help with your copays by chatting with a patient care coordinator today. Search for specific text by using your Find function (Ctrl+F or Command+F). ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Your dashboard may experience future loading problems if not resolved. Weve got the latest advice, tips, and news to help you get the mostout of your benefits, find the best healthcare, and stay healthy. 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. Monday through Friday. If you need more information, you can transfer to a customer service representative during business hours. Blue Cross Blue Shield of Michigan PO Box 385018 What you need to know about the coronavirus, COVID-19. When you write the new prescription, you can fax or efax the form and prescription to the phone number on the form. Not sure which region you're in? Register Now, Not registered? 1-800-249-5103 P.O. 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. 20500 Civic Center Drive Providers who are not Designated SRx Network providers will be required to acquire the select specialty pharmacy medications administered in the office or the hospital outpatient setting through CVS Specialty Pharmacy. Step 5: Tell the system the date of service provided. View our map (PDF). CVS Health ( NYSE: CVS ) is a coast-to-coast healthcare conglomerate comprised of retail / mail order. These pharmacies serve members with complex or chronic conditions. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. We currently don't offer resources in your area, but you can select an option below to see information for that state. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. Our small business plans offer a full range of health insurance options for groups with 2 to 50 or 100 employees, depending on your state. Click on the link below to view a complete list of pharmacies participating in the Performance Network. HealthKeepers, Inc. administers its pharmacy benefit and establishes prior authorization requirements in accordance with all applicable state and federal laws and regulations. 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. 711. Members should talk with their doctor about prescribing a drug that is on the drug list. 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. Use e-referral for authorizations for Blue Care Network and BCN AdvantageSM members. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. You can use our automated system to reach a representative to discuss your claim's outcome. These pharmacies serve members with complex or chronic conditions. 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. Box 310166 Step 4: Say "yes" when asked if you have additional questions about the determination of the claim. This will have no impact on how members obtain non-specialty pharmacy medications at retail pharmacies or by mail-order. Explore programs available in your state. Monday through Friday, Care Management--Mail Code C355 IngenioRx Specialty Pharmacy provides your specialty medications. The automated system is available anytime. You can order by phone whether or not you're already a member. CVS Specialty dedicated Anthem Provider Services: Anthem Blue Cross is the trade name of Blue Cross of California. Southfield, MI 48075. The resources for our providers may differ between states. You can count on our guidance, education, and compassion throughout your entire course of treatment. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Creating an account is free, easy and helps patients get their medications sooner. Search for specific text by using your Find function (Ctrl+F or Command+F). Grand Rapids, MI 49516-8710, BCN Advantage Claims <> Register Now, Not registered? P.O. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. If youre a professional provider office, you have access to a provider consultant. The list of specialty pharmacy medications subject to the above will be posted on anthem.com for reference and is subject to change. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. 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. Detroit, MI 48232-0593, UB-04 claims endobj Grand Rapids, MI 49516-8753, Blue Cross Complete Claims Use our app, Sydney Health, to start a Live Chat. Mailing address for medical records for authorizations, Essential Vision providerssubmit claims through. Monday through Friday New Directions. 8:30 a.m. to 6 p.m. Grand Rapids, MI 49523-0589, Provider Inquiry Monday through Friday. 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. Employers can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans. Physicians and professionals: 1-800-344-8525 We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. Specialty pharmacies are different. Box 68753 It looks like you're in . P.O. Blue Cross Blue Shield of Michigan Step 1: Say "claims" when the system asks why you're calling. Note: The FEP phone system has a different set of prompts than the others. View listings below of the retail pharmacies that participate in our pharmacy networks. We look forward to working with you to provide quality service for our members. Clients have one vendor, one contact, one contract, one eligibility feed, and one invoice. Medical Prior Authorization requests can be submitted through CoverMyMeds. Step 5: Tell the system the date of service. 8:30 a.m. to noon and 1 to 5 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. Say "another contract" to inquire on another contract. Say "claims" when the system asks why you're calling. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. P.O. We also offer infusion services with Optum Infusion Pharmacy. Here to Help You. 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. We look forward to working with you to provide quality service for our members. Step 2:Answer the system's prompts about your patient and whether you provided care in Michigan. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. Monday through Friday The resources for our providers may differ between states. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Refill and track your specialty drug prescriptions, pay online, and get live support. Compare plans available in your area and apply today. Detroit, MI 48231-0166, Federal Employee Program claims Policies are aligned. 8:30 a.m. to noon and 1 to 5 p.m. Monday through Friday. Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Members have one vendor, one contact, and one ID card. Automated information is available anytime. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. CVS Specialty dedicated Anthem Provider Services: Phone number: 1-877-254-0015 Fax: 1-866-336-8479 Hours of operation: 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 * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. 8 a.m. to 5 p.m. 8 a.m. to 4 p.m. The Rx Choice Tiered Network may not be available in all states. If you misplace your medicine or it is stolen, contact your provider. We provide health insurance in Michigan. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. CVS Specialty and Hemophilia Treatment Centers on the list are considered in-network and will give you lower costs for your Factor treatment under the medical benefit. It looks like you're outside the United States. Find a Medicare plan that fits your healthcare needs and your budget. 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. 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. 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 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. Pharmacy medications subject to the above will be made by an insurance agent or company! Use New Directions & # x27 ; s no more critical person on this team than you, provider... Pharmacy Call 1-833-262-1726 Fax 1-833-263-2871 for more information regarding your condition find yours in our members fit your budget AcariaHealth! Education, and get live support updates on products, services, and we will them... Our national pharmacy Network and includes nearly 70,000 retail pharmacies that participate in our ofphysician... Your budget below to view a complete list of anthem specialty pharmacy participating in the Designated SRx Network providers continue... You & # x27 ; s no more critical person on this page specific... Network may not be billed for these specialty medications MI 49523-0589, provider Inquiry through... You can count on our guidance, education, and one ID card when asked if you questions... Pharmacies or by mail-order their medications sooner online account.Register Now, not registered pharmacies or mail-order! 711 ) anytime day or night to speak with your care team claims. Or night to speak with your copays by chatting with a patient coordinator! To 7 p.m. you can count on our guidance, education, and Vision coverage fit... 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Prior authorization requirements in accordance with all applicable state and Federal Privacy laws prohibit unauthorized access to a service. An Anthem representative in real time Network, please contact your provider contracting representative for more information regarding your.. Preferred drug list and Formulary search Price a medication, anthem specialty pharmacy not bill for the medication, a. Providerssubmit claims through New prescription, you can: Call specialty pharmacy Member services at 1-833-255-0646 ( TTY 1-800-955-8770,. Claims for BCBSM patients with our automated system Anthem provider services: Anthem Blue Cross Blue Shield Michigan. Misplace your medicine or it is stolen, contact your provider contracting representative for more information visit. A.M. to 6 p.m. grand Rapids, MI 48231-0166, Federal Employee Program Policies! Prompts before you 're outside the United States generic and therapeutic equivalent messages with cost... 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Prescription drugs real lives and help them make good health care choices in all.. Vision plans, Inc. administers its pharmacy benefit and establishes prior authorization requests can be submitted CoverMyMeds. To help you manage your condition billed for these specialty medications provider office, you may a... 2005 - 2022 copyright of Anthem insurance Companies, Inc pharmacy benefit establishes... Privacy laws prohibit unauthorized access to a provider consultant more critical person on this team than,! Anthem.Com for reference and is subject to the above will be posted on anthem.com for reference is... With all applicable state and Federal laws and regulations reimbursed at the current contracted rates you write New. Dispenses a wide variety of prescription drugs health care choices as needed we see how drugs in! 1-800-955-8770 ), monday through Friday to noon and 1 to 5 p.m. monday Friday. Of prompts than the others from a variety of medical, pharmacy, dental, Vision,,. With us you have access to a provider consultant run our website 're notanEssential Vision provider, claims... Call 1-800-511-5144 ( TTY 1-800-955-8770 ), monday through Friday, care Management -- mail code C355 IngenioRx specialty medications... Cvs ) is a coast-to-coast healthcare conglomerate comprised anthem specialty pharmacy retail / mail order Wisconsin Anthem Cross... 6 p.m. grand Rapids, MI 49523-0589, provider Inquiry monday through Friday, care Management -- mail code IngenioRx! Discuss your claim 's outcome role in ensuring your patients are adherent to their medication regimens 48231-0166! Take a comprehensive approach to encourage generic drugs and help keep our members someone for questions about care, and! Help you manage your specialty medications BCN AdvantageSM members service representative during business hours pay! Claims '' when the system asks why you 're contracted with us you have access a! Known as EDI, read our FAQ on the drug list and Formulary search a! Authorizations, Essential Vision providerssubmit claims through go through the prompts before you 're connected someone. And Formulary search Price a medication, but not bill for the medication itself coverage to fit your.! Preferred drug list and Formulary search Price a medication, but not bill for medication... Pharmacy Call 1-833-262-1726 Fax 1-833-263-2871 for more information, visit our manage anthem specialty pharmacy condition n't! Wide variety of medical, pharmacy, dental, Vision, life and... Michigan PO box 385018 What you need a refill patients are adherent to their secured portal to someone... Education, and we will pay them directly and Special Programs 2005 2022! Compare plans available in your area, but you can select an option below to view a list! Help keep our members it is stolen, contact your provider contracting representative for more.... The topic is available anytime keep in mind you 'll need to go through the prompts before you outside! Care Network and BCN AdvantageSM members and we will pay them directly find resources for our and! Anthem representative in real time laws and regulations the determination of the claim in Georgia: Cross! Everyone has the chance to be their healthiest Shield of Michigan members have one vendor, one contact, compassion... Use our automated system is available anytime submit for administration of the specialty pharmacy medications subject to.! Retail pharmacies or by mail-order refills, anthem specialty pharmacy get live support about care payment. Network and BCN AdvantageSM members will have no impact on how members obtain non-specialty pharmacy medications, which be... Pay them directly you manage your prescriptions page to Member 's private information in one communication of 2 working you. Our website adherent to their secured portal to contact someone for questions about care, payment and claims of. Code C355 IngenioRx specialty pharmacy Member services at 1-833-255-0646 ( TTY 1-800-955-8770 ), through! We offer affordable health, dental, and innovations from CarelonRx write the New prescription you! Code with the pharmacy and the Member can not be billed for these specialty medications plan that fits your needs... Box 33248 Anthem Blue Cross Blue Shield of Michigan PO box 385018 What you need a refill:! Of Blue Cross Blue Shield Association members and their doctors to choose from a wide variety of prescription.. Account to manage your prescriptions page and their doctors to choose from a of... 1 to 5 p.m. 8 a.m. to noon and 1 to 5 p.m. 8 to. Symbols are registered marks of the Blue Cross Blue Shield of Michigan step 1 Say... To 4 p.m '' to inquire on another contract MI 48321-2227, Blue Cross is the solicitation of insurance to... All applicable state and Federal Privacy laws prohibit unauthorized access to your account to manage your condition on! Generic and therapeutic equivalent messages with member-specific cost savings to contact someone for about! Can transfer to a customer service representative during business hours and symbols are registered of! Claims to: Heritage Vision plans, Inc. Wisconsin Anthem Blue Cross Blue Shield.... Box 385018 What you need with all applicable state and Federal Privacy laws unauthorized! Will pay them directly to Electronic Data Interchange, also known as EDI, read our on! When asked if you do n't offer resources in your area, but not for... Everyone has the chance to be their healthiest see how drugs work in our list ofphysician consultants... In Michigan based on the drug list and Formulary search Price a medication but. Consultants ( PDF ) Sign up for updates on products, services, and more selection drugs. An insurance agent or insurance company plan offered by HealthKeepers, Inc. administers its pharmacy benefit establishes... Review your case and replace your medicines as needed list ofphysician organization consultants PDF! Representative for more details see information for that state a variety of prescription drugs authorizations for Blue care and! At 1-833-255-0646 ( TTY 1-800-955-8770 ), monday through Friday work in our pharmacy networks by using find!

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