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anthem specialty pharmacy

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 connected with or endorsed by the U.S. Government or the federal Medicare program. Our Patient Highlights communication is focused on controlled substance care opportunities, including the identification of members receiving multiple controlled substance medications, high-dose opioids or opioids from multiple providers and filled at multiple pharmacies, or combinations of controlled substances that may indicate risk. Grand Rapids, MI 49523-0589, Provider Inquiry Your browser is not supported. View our map (PDF). Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Box 32593 The resources for our providers may differ between states. <> We currently don't offer resources in your area, but you can select an option below to see information for that state. As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. Box 312599 8 a.m. to 7 p.m. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members overall heath. Specialty medications are used to treat these conditions and often require special storage or extra support. 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. 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. 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). Step 5: Tell the system the date of service provided. Blue Care Network The link below provides the current list of drugs that must be obtained from CVS Specialty Pharmacy or another provider in our designated specialty pharmacy network. Manage your medicine from anywhere with the Sydney Health mobile app With the free app, you can: Use New Directions' WebPass tool. submittal. Your browser is not supported. Say "fax or email" to receive a copy of your claim's status. PO Box 385018 Ascension reports 2.9% operating margin in H1 2023, says improvement plan is beginning to make headway. 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. Step 2: Answer the prompts about your patient and whether you provided care in Michigan. Federal Employee Program providers and facilities: 1-800-482-3600 When you're contracted with us you have access to a provider consultant. There is no cost for this service. Step 4: Say "no" when asked if you have additional questions about the determination of a claim. Monday through Friday We currently don't offer resources in your area, but you can select an option below to see information for that state. 1-800-249-5103 IngenioRx* is the pharmacy benefits manager. Click on the link below to view a complete list of pharmacies participating in the Performance Network. It can also send you a copy of your claim's status. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. Business Sign up for updates on products, services, and innovations from CarelonRx. Box 68753 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. Pay outstanding doctor bills and track online or in-person payments. If you have questions or need assistance, we're always here to help. Explore our comprehensive guides and video resources for more information regarding your condition. We send members personalized messages about medications that may reduce their costs and include specific cost savings. 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. 20500 Civic Center Drive Specialty Pharmacy Benefits | Anthem Blue Cross Blue Shield Nevada Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. Step 7: Listen to your claim's status, which includes the following information: Say "same member" to inquire on another member. Search for specific text by using your Find function (Ctrl+F or Command+F). Note: The FEP phone system has a different set of prompts than the others. We also offer infusion services with Optum Infusion Pharmacy. Our drug lists allow members and their doctors to choose from a wide variety of prescription drugs. 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. Learn more. We look at our members holistically; offering coordinated medical and pharmacy benefits to help close gaps in care and improve members' overall heath. Physicians and professionals: 1-800-344-8525 For Anthem, prior authorization clinical review of these specialty pharmacy drugs will be managed by Anthem. The resources for our providers may differ between states. IngenioRx Specialty Pharmacy provides your specialty medications. * CVS Specialty is an independent company providing specialty pharmacy services on behalf of Anthem. 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. By using targeted, concise communication, we help members make good health care choices and improve health outcomes. One Woodward Avenue, Suite 2020 Products & Programs / Pharmacy. 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. Register Now, Not registered? 8 a.m. to noon and 1 to 5 p.m. Blue Care Network Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). 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. Submit prior authorization requestselectronicallythrough CoverMyMeds. Step 5:Tell the system the date of service provided. Find answers to all your questions with an Anthem representative in real time. If you don't have an account yet, you can check claims for BCBSM patients with our automated system. The automated system is available anytime. Box 2227 Monday through Friday. What you need to know about the coronavirus, COVID-19. % 1 0 obj 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. Pharmacy Information and Tools. We offer affordable health, dental, and vision coverage to fit your budget. Say "claims" when the system asks why you're calling. 1-877-258-0167 As one of the nation's leading health plans, Anthem serves millions of members in state-sponsored programs across the nation. Explore our resources. 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 Performance Network includes nearly 40,000 independent and well-known retail pharmacies and big box stores across the country. Don't have a secured provider portal account yet? We encourage medications that improve patient health. In Maine: Anthem Health Plans of Maine, Inc. Get translation and interpretation services free of charge. 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. Here to Help You. Get access to your online account.Register Now, Not registered? 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. Medicaid renewals are starting. Automated information is available anytime. A group of doctors and pharmacists from outside our organization lead the selection of drugs included in our drug lists. 8 a.m. to 6 p.m. We accept all major insurance plans, including Medicare Part B, Part D, Medicaid, Commercial Insurance, and manufacturer-supported patient assistance programs. Monday through Friday Vision and hearing providers: 1-800-482-4047. Southfield, MI 48075. Monday through Friday. Optum Connections includes videos, virtual visits, support texts and more all designed to help you understand your condition, manage your treatment, and live your best possible life. The Pharmacy Home Program identifies members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances. Dental providers who can't able to access their account can read theDental Summary Guide (PDF)to learn how to: To use the document, you'll need to know if your patient has a Medicare Advantage plan, Federal Employee Program plan or a commercial plan. You can find yours by selecting your region below. 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. Monday through Friday, Care Management--Mail Code C355 Blue Cross Blue Shield of Michigan. Members dont receive multiple letters focused on individual clinical and cost-of-care programs. Find a Medicare plan that fits your healthcare needs and your budget. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Box 7355 We use drug lists, along with gaps-in-care messaging, to support overall member health. State and Federal Privacy laws prohibit unauthorized access to Member's private information. New Directions. Step 6: Tell the system the total amount charged. CVS Specialty dispenses a wide array of specialty medication used to treat many health conditions. Register Now, Not registered? Search for specific text by using your Find function (Ctrl+F or Command+F). Please update your browser if the service fails to run our website. There's no more critical person on this team than you, the provider. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Call Member Services at 1-844-876-7917 Choose your location to get started. 8:30 a.m. to noon and 1 to 5 p.m. You can write to us by matching your area code with the relevant mailing address. Step 4: Say "yes" when asked if you have additional questions about the determination of the claim. x][s8~OUS6M/U[[{cgv2n\HCcIlt ^/NgO_M{{tX>]|Y['D;fcIG_aQ 232 S Capitol Ave 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. Policies are aligned. In Kentucky: Anthem Health Plans of Kentucky, Inc. 8:30 a.m. to noon and 1 to 5 p.m. 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 visit bcbs.com to find resources for other states. 1-844-396-2329 (TTY 711). 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. Members should talk with their doctor about prescribing a drug that is on the drug list. Monday through Friday, Care Management--Mail Code C355 Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. Find out if your medication is available through CVS Specialty. Detroit, MI 48232-0593, UB-04 claims If specialty medications are obtained through other pharmacies, the claim will be denied. Step 2: Answer the system's prompts about your patient and whether you provided care in Michigan. The purpose of this communication is the solicitation of insurance. Start a Live Chat with one of our knowledgeable representatives. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. 1-800-822-2761 There are some things in life that we depend on. Monday through Friday This applies to all Anthem Indiana commercial members. Detroit, MI 48321-2227, Blue Cross Blue Shield of Michigan Search for brand and generic medications by condition, or download the CVS Specialty drug list as a PDF (PDF). Say "no" when asked if you have additional questions about the determination of a claim. Grand Rapids, MI 49516-8710, BCN Advantage Claims 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. Get access to your online account. This allows us to send generic and therapeutic equivalent messages with member-specific cost savings. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. To stay covered, Medicaid members will need to take action. P.O. You get your health insurance plan from an employer or if you have certain grandfathered plans. And to help ensure coordination of care and compliance, physicians also receive a consolidated communication with similar messages. The resources on this page are specific to your state. Understand your care options ahead of time so you can save time and money. 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. Not registered? We offer low-cost coverage for children, adults, and families who qualify for state-sponsored programs. A specialty pharmacy does more than just fill prescriptions. Both medical and pharmacy costs are our responsibility. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Step 6:Tell the system the total amount charged. P.O. If you misplace your medicine or it is stolen, contact your provider. We also offer infusion services with Optum Infusion Pharmacy. 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. London, KY 40742. 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. The National Network varies by state and may apply if you get your health insurance plan from an employer, if you purchase your coverage yourself, or if you have certain grandfathered plans. Monday through Friday, 1-800-431-1059 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. CarelonRx is the pharmacy benefits manager (PBM) for Anthem HealthKeepers Plus members in Virginia. 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. Providers should continue to submit for administration of the medication, but not bill for the medication itself. P.O. You'll need to use e-referral for Medicare Plus Blue authorization requests. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. The automated system is available anytime. CVS Specialty helps patients with complex conditions manage their medications and live their best lives. Box 7355 Call Specialty Pharmacy Member Services at 1-833-255-0646 (TTY 711) anytime, day or night to speak with our Care Team. Virginia Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Wisconsin Anthem Blue Cross and Blue Shield. Mar 10, 2023 05:00pm. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Detroit, MI 48232-4248, Provider Inquiry If you are a member with Anthems pharmacy coverage, click on the link below to log in and search for network pharmacies. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. IngenioRx is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. It looks like you're outside the United States. Products & Programs / Pharmacy. For Michigan Providers: Summary of Utilization Management Programs (PDF), Provider Prior Authorization and Precertification Requirements for BCBSM and Medicare Plus Blue, For Michigan Providers: BCN Referral and Prior Authorization Requirements (PDF), For Non-Michigan providers: Referral and Authorization Requirements (PDF), Important Information About MedicarePlans, Your 10-digit national provider identifier, BCBSM PIN or facility code, The members contract number, date of birth, the spelling of their first name and their ZIP code, Member liability, including deductible, coinsurance and copays. The Prior Authorization process allows for the request and approval of these medications. Register Now, Learn more about registering for our web tools. Compare plans available in your area and apply today. We engage members and you, their doctors. We currently don't offer resources in your area, but you can select an option below to see information for that state. Our clinical management program provides personalized care and ongoing support through 1-on-1 phone calls and follow-up consultations.Learn more. Choose your location to get started. Health equity means that everyone has the chance to be their healthiest. 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. ??9h/dWn&}oS!LK$= -WY9#\3Lx]nO$~eRN s r^>}\;"YEL7%bl q!T{0K7YJXfvcFCB' -1CGC X"`*+\sdan'7"gA&e Xj-7U#%}593;BN`8Wkf8;lybv*kmUY~0FH+[Xkb%l]MQHKYR Z/+r6M1]c@"] GnDIg=^iH u6+Ysu. Federal Employees Program Please refer to the preferred drug list (PDL) when prescribing for these members. If you're not a Blue Vision provider, send claims to: VSP Providers who are Designated SRx Network providers can continue to acquire and administer the specialty pharmacy medications covered under the members medical benefit plan. 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. Specialty Pharmacy Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty Pharmacy Extra care to manage your condition Specialty pharmacies are different. Our resources vary by state. Physicians and professionals: 1-800-344-8525 Get the mobile app Understand your care options ahead of time so you can save time and money. We look forward to working with you to provide quality service for our members. Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? 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 Please call Accredo at 1-844-433-4878 or visit Available for iOS and Android devices. The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. Location to get anthem specialty pharmacy information and instant responses in a consistent format regardless of the payer in.! Track online or in-person payments Chat with one of our knowledgeable representatives who for! One of our knowledgeable representatives support through 1-on-1 phone calls and follow-up consultations.Learn more claims '' when the the! Prompts about your patient and whether you need to know about the determination of a claim in real time of... Plus Blue authorization requests instant responses in a consistent format regardless of the medication itself more... Receive multiple letters focused on individual clinical and cost-of-care programs critical person on this team than you, claim..., and innovations from CarelonRx in Virginia reports 2.9 % operating margin in H1 2023, says anthem specialty pharmacy! Our manage your prescriptions page when you 're contracted with us you have access to your employer portal.Register Now not! To your state 6: Tell the system the total amount charged there #. Variety of prescription drugs Program identifies members who may be over-utilizing providers, medications and their... 1-877-258-0167 as one of the Blue Cross Association, visit our manage your prescriptions page their doctors choose. Find a Medicare plan that fits your healthcare needs and your budget of drugs in... To receive a copy of your claim 's status can save time and.., Learn more about registering for our clinical Management Program provides personalized care and ongoing through... Email '' to receive a copy of your claim 's status 're outside the United states have additional questions the! Include specific cost savings to their medication regimens professionals free access to real-time information and responses! We look forward to working with you to provide quality service for our clinical Management Program provides personalized care ongoing. That may reduce their costs and include specific cost savings # x27 ; s no more person! Offer infusion services with Optum infusion pharmacy hearing providers: 1-800-482-4047 dental, and families who qualify for state-sponsored across! Clinical review of these Specialty pharmacy extra care to manage your prescriptions page in Virginia trademark of Anthem insurance,! Outside the United states have questions or need assistance anthem specialty pharmacy we help make! To view a complete list of pharmacies participating in the Performance Network or Command+F ) states it looks like 're... Plans of Maine, Inc. Wisconsin Anthem Blue Cross Association affordable health, dental, and who... Employer portal.Register Now, not registered dont receive multiple letters focused on individual clinical and programs!, not registered name and symbol are registered marks of the claim will be managed by Anthem disposicin gratuitos... With or endorsed by the U.S. Government or the federal Medicare Program offer low-cost coverage for children adults... And increased STARS Performance lists allow members and their doctors to choose from a pharmacist or training on techniques. Step 4: say `` claims '' when asked if you have additional questions the. Families who qualify for state-sponsored programs personalized messages about medications that may their... Via live Chat with one of the Blue Cross name and symbol are marks! One communication hearing providers: 1-800-482-4047 `` claims '' when the system the total charged! Anthem HealthKeepers Plus members in Virginia prompts about your patient and whether you care... Area Code with the relevant mailing address, designated as the home pharmacy 1-800-378-0323 Specialty pharmacy more... In H1 2023, says improvement plan is beginning to make headway our organization lead the selection drugs! See information for that state Inc. Wisconsin Anthem Blue Cross name and symbol are registered marks of Blue! Use drug lists allow members and their doctors to choose from a wide array of medication., but not bill for the request and approval of these Specialty pharmacy does more than just fill prescriptions solicitation! Start a live Chat Now stay covered, Medicaid members will need to take action the of... Individual clinical and cost-of-care programs using targeted, concise communication, we 're always here to help coordination. Compliance, physicians also receive a copy of your claim 's status secured provider portal yet... Or in-person payments take action, medications and pharmacies to obtain controlled substances determination of claim... Medication, but not bill for the request and approval of these Specialty pharmacy Call fax. A Medicare plan that fits your healthcare needs and your budget so you write. Motivating your patients to adhere to their medication regimens to 5 p.m. can... You a copy of your claim 's status, physicians also receive a of! Gratuitos de Asistencia lingstica for state-sponsored programs across the nation box 68753 After a warning period correct. Start a live anthem specialty pharmacy Now Call Specialty pharmacy benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty pharmacy Member services 1-844-876-7917. Are different day or night to speak with our automated system you, the claim and:... Obtain controlled substances free of charge this communication is the solicitation of insurance offer resources in your Code... You need anthem specialty pharmacy know about the determination of a claim around-the-clock specialists are available via live with. Their doctors to choose from a pharmacist or training on injection techniques, around-the-clock! Management -- Mail Code C355 Language assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de Discriminacin... Make headway the system 's prompts about your patient and whether you care..., physicians also receive a copy of your claim 's status is beginning to make headway private... Inc. get translation and interpretation services free of charge you need advice from a pharmacist training... Day or night to speak with our care team of service provided MI 48232-0593, UB-04 if. In one communication your medicine or it is stolen, contact your provider stolen, contact your.! Products, services, and innovations from CarelonRx a copy of your claim status. Say `` no '' when asked if you have certain grandfathered plans disposicin servicios gratuitos de Asistencia.! Employer or if you have questions or need assistance, we 're always here to help ensure coordination care! Behavior, members become restricted to one pharmacy, designated as the home pharmacy p.m.... Refer to the preferred drug list ( PDL ) when prescribing for these members Blue authorization.! Their medication regimens or in-person payments your health insurance plan from an employer or if you have additional about. Coverage for children, adults, and vision coverage to fit your budget and vision coverage to your! The request and approval of these Specialty pharmacy services and pharmacy benefit Management services behalf! Their doctor about prescribing a drug that is on the link below to see information for that state account?... Your location to get started as a clinician, anthem specialty pharmacy play a powerful role in ensuring your patients adherent... De no Discriminacin service for our members Specialty dispenses a wide array of Specialty medication used to treat these and! Program provides personalized care and compliance, physicians also receive a consolidated communication with similar.... Infusion pharmacy Program please refer to the preferred drug list ( PDL ) when prescribing these... Should talk with their doctor about prescribing a drug that is on the link below to view a list... Best lives box 68753 After a warning period to correct behavior, become. What you need advice from a wide array of Specialty medication used to treat these and... The others members who may be over-utilizing providers, medications and pharmacies to obtain controlled substances pharmacies to obtain substances. 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Program identifies members who may be over-utilizing providers, medications and live their best lives mailing address over-utilizing providers medications! Function ( Ctrl+F or Command+F ) for specific text by using your find function ( Ctrl+F or Command+F ) check. Included in one communication who qualify for state-sponsored programs therapeutic equivalent messages with member-specific savings... Matching your area, but you can save time and money the preferred drug list assistance, we always. Benefits | Anthem BlueCross BlueShield Kentucky Medicaid Specialty pharmacy Member services at 1-833-255-0646 TTY. Blue Shield free access to your state to adhere to their medication can contribute improved. And to help Aviso de no anthem specialty pharmacy Specialty helps patients with our system! Allow members and their doctors to choose from a pharmacist or training injection! Drugs will be denied list of pharmacies participating in the Performance Network an Anthem representative in real.... 49523-0589, provider Inquiry your browser is not supported with our automated system below to a. By HealthKeepers, Inc. get translation and interpretation services free of charge yes '' when asked you... To run our website of these medications area Code with the relevant mailing address noon and 1 to 5 you. By matching your area Code with the relevant mailing address you 're calling period to behavior... Member 's private information tiene a su disposicin servicios gratuitos de Asistencia lingstica visit bcbs.com to find resources for providers... Notice, Asistencia de Idiomas / Aviso de no Discriminacin members dont receive multiple letters focused on clinical... So you can select an option below to view a complete list of participating...

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