ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. * Services may be listed as requiring precertification (prior authorization) that may not be covered benefits for a particular member. Type at least three letters and well start finding suggestions for you. Availity provides administrative services to BCBSIL. Some procedures may also receive instant approval. Contact 866-773-2884 for authorization regarding treatment. Follow the step-by-step instructions below to design your anthem forms: Select the document you want to sign and click Upload. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Please verify benefit coverage prior to rendering services. For costs and complete details of the coverage, please contact your agent or the health plan. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. cost of services to the member if denied by Anthem for lack of medical necessity: (1) Procedures, equipment, and/or specialty infusio n drugs which have medically necessary criteria determined by Corporate Medical Policy or Adopted Clinical Guidelines. 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. Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore, AIM or Availity. In Kentucky: Anthem Health Plans of Kentucky, Inc. The Anthem Alliance EPO 2022 prior authorization list has been updated effective January 1, 2022. 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. BlueCross BlueShield of Tennessee uses a clinical editing database. CareFirst Commercial Pre-Service Review and Prior Authorization. 477 0 obj <>/Filter/FlateDecode/ID[<530E5E682DBDAA468541E11BFAD96BAD>]/Index[451 44]/Info 450 0 R/Length 122/Prev 255106/Root 452 0 R/Size 495/Type/XRef/W[1 3 1]>>stream (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.). COVID-19 Information - New Hampshire - Publication RETIRED as of November 8, 2022. Not connected with or endorsed by the U.S. Government or the federal Medicare program. In the event that the emergency room visit results in the members admission to the hospital, providers must contact Anthem within one business day following admission or post-stabilization. Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Medi-Cal Managed Care and Major Risk Medical Insurance Program Provider Manual. Please check your schedule of benefits for coverage information. 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 Independent licensees of the Blue Cross and Blue Shield Association. Mar 1, 2022 In the event of an emergency, members may access emergency services 24/7. 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. Select Auth/Referral Inquiry or Authorizations. Home Employer Federal Employees Blue Cross And Blue Shield Service Benefit Plans Medical Plans In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Pharmacy Forms. Choose My Signature. National Accounts, Posts about using health Insurance and managing your health, Collections of learning resources and links to services, For Sydney Health users connect with others and find care programs. Long-Term Care (LTC) Forms. Forms and information about pharmacy services and prescriptions for your patients. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Medicare Advantage Providers Anthem offers a variety of Medicare plans to support member needs. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. This list may vary based on account contracts and should be verified by contacting 1-866-773-2884. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First To get started, select the state you live in. These documents contain information about upcoming code edits. Anthem offers great healthcare options for federal employees and their families. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. We look forward to working with you to provide quality services to our members. Inpatient Clinical: 800-416-9195. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Medical Clearance Forms and Certifications of Medical Necessity. Forms and information about behavioral health services for your patients. Anthem Blue Cross and Blue Shield (Anthem) recommends submitting precertification requests via Interactive Care Reviewer (ICR), a secure utilization management tool available in Availity. PPO outpatient services do not require Pre-Service Review. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Musculoskeletal (eviCore): 800-540-2406. Commercial Prior Authorization Summary and Code Lists endstream endobj startxref Electronic authorizations. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Large Group These manuals are your source for important information about our policies and procedures. The form contains important information regarding the patient's medical history and requested medication which Anthem will use to determine whether or not the prescription is included in the patient's health care plan. For 2021, there were no changes to overall care categories, but some of the codes within certain categories may have been updated. hbbd```b``+d3d] fIM|0+d:"Y`XM7`D2HO H2Xb R?H?G _q Prior authorization requirement changes effective June 1, 2022 Mar 1, 2022 State & Federal / Medicare On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. 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. Prior Authorization Contact Information Providers and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal) Phone: 1-888-831-2246 Hours: Monday to Friday, 8 a.m. to 5 p.m. Fax: 1-800-754-4708 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. 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). (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 requirements and coverage may vary from standard membership and will be documented in additional information sections. 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. Administrative. Phone - Call the AIM Contact Center at 866-455-8415, Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays. The list below includes specific equipment, services, drugs, and procedures requiring review and/or supplemental documentation prior to . Learn about the NAIC rules regarding coordination of benefits. Independent licensees of the Blue Cross Association. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. The purpose of this communication is the solicitation of insurance. Prior Authorization for Certain Hospital Outpatient Department (OPD) Services Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items Review Choice Demonstration for Home Health Services Return to Top Use the Prior Authorization tool within Availity, or Contact Provider Services To submit a precertification request: Log in to Availity. Get the latest news to help improve your life and keep you healthy. If you have any questions, call the number on the members ID card. You can also refer to the provider manual for information about services that require prior authorization. Expedited fax: 888-235-8390. Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Select Patient Registration from the top navigation. Code pairs reported here are updated quarterly based on the following schedule. Use Availity's electronic authorization tool to quickly see if a pre-authorization is required for a medical service or submit your medical pre-authorization request. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Independent licensees of the Blue Cross Association. 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. Contact 866-773-2884 for authorization regarding treatment. The services marked with an asterisk (*) only require Pre-Service Review for members enrolled in BlueChoice products if performed in an outpatient setting that is on the campus of a hospital. Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). . Please reference the Blues & CDHP Products Prior Authorization List on the Prior Authorization webpage. There are three variants; a typed, drawn or uploaded signature. Please use the The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. Enhanced Care Management (ECM) under CalAIM is a care management benefit that is community-based and provides a whole person approach to care that addresses the clinical and nonclinical needs of members with the most complex medical and social needs. Please refer to the criteria listed below for genetic testing. 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. Use of the Anthem websites constitutes your agreement with our Terms of Use. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. 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. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. In Indiana: Anthem Insurance Companies, Inc. Do not sell or share my personal information. Information about benefits for your patients covered by the BlueCard program. Most PDF readers are a free download. Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022. Noncompliance with new requirements may result in denied claims. 2022 Standard Pre-certification list . 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. 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. 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). With three rich options to choose from, weve got you covered. 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. You may also view the prior approval information in the Service Benefit Plan Brochures. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. View the list of services below and click on the links to access the criteria used for Pre-Service Review decisions. 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. Updated June 02, 2022. February 2023 Anthem Provider News - Virginia, New ID cards for Anthem Blue Cross and Blue Shield members - Virginia, Telephonic-only care allowance extended through April 11, 2023 - Virginia, January 2023 Anthem Provider News - Virginia, December 2022 Anthem Provider News - Virginia, Medicare Advantage Providers | Anthem.com, March 2022 Anthem Provider News - Virginia, K1022 Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type. Please verify benefit coverage prior to rendering services. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Type at least three letters and well start finding suggestions for you. 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. 844-912-0938 Email: OhioMedicaidProvider@anthem.com Prior authorization resources and contact information Services Requiring Prior Authorization Inpatient prior authorization fax numbers Physical health: 877-643-0671 Behavioral health: 866-577-2184 Medicaid prior authorization: 800-964-3627 Outpatient prior authorization fax numbers CareFirst reserves the right to change this list at any time without notice. This list contains notification/prior authorization requirements for inpatient and outpatient services. 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. For more information, please refer to the Medical Policy Reference Manual. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification. Prior Authorization Requirements. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services (CMS) guidelines, including definitions and specific contract provisions/exclusions take precedence over these precertification rules and must be considered first when determining coverage. In 2020, Part B step therapy may apply to some categories . 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. We encourage providers to use Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Customer Care Center hours are Monday to Friday 7 a.m. to 7 p.m. After hours, verify member eligibility by calling the 24/7 NurseLine at. 1 Cameron Hill Circle, Chattanooga TN 37402-0001, Change of Ownership and Provider ID Number Change Information. Visit our PharmacyInformation page for formulary information and pharmacy prior authorization forms. %%EOF Please note: This change is not applicable to the members enrolled in the Mercy Co-worker Plan as they have a customized prior authorization list. Here youll find information on the available plans and their benefits. U.S. Department of Health & Human Services, National Association of Insurance Commissioners, Medicare Complaints, Grievances & Appeals. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. State & Federal / Medicare. ). 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 site may also contain non-Medicare related information. * Once logged in to Availity at http://availity.com, select Patient Registration > Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry, as appropriate. Commercial non-HMO prior authorization requests can be submitted to AIM in two ways. 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. From cleanings to crowns, BCBS FEP Dental coverage options are available for federal employees, retirees, and eligible retired uniformed service members. Online - The AIM ProviderPortal is available 24x7. Do not sell or share my personal information. Effective 01/01/2023 (includes changes effective 04/01/2023) . This approval process is called prior authorization. It clarifies a utilization management vendor change for specific members. In Kentucky: Anthem Health Plans of Kentucky, Inc. Commercial. Part B Step Therapy (204 KB) Drug step therapy is a type of prior authorization that requires one drug (or drugs) to be tried for a medical condition prior to utilizing other drugs; the steps typically require lower cost drugs or drugs with better clinical outcomes to be tried first. In Ohio: Community Insurance Company. The Blue Cross name and symbol are registered marks of the Blue Cross Association. On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. As your health needs evolve, our diverse plans are designed to evolve with you. Please check your schedule of benefits for coverage information. You can also check status of an existing request and auto-authorize more than 40 common procedures. Note: Blue High Performance NetworkSM (BlueHPNSM) members have limited benefits at the University of Maryland Medical System Downtown Campus. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. 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. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists Availity Portal for behavioral health authorizations, or contactProviderServices for assistance. Its important to remember that benefit plans differ in their benefits, and details such as prior authorization requirements are subject to change. 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). This article offers an overview of 2021 prior authorization support materials and related communications that may apply for some of our non-HMO commercial and government programs members, effective Jan. 1, 2021. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Providers and staff can also contact Anthem for help with prior authorization via the following methods: Pharmacy Prior Authorization Center for Medi-Cal: *For Medicare-Medicaid Plan pharmacy requests, please contact Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Care at 855-817-5786. Call our Customer Service number, (TTY: 711). eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. endstream endobj 452 0 obj <. 2020 copyright of Anthem Insurance Companies, Inc. HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. Medicare with Medicaid (BlueCare Plus SM ) Medicaid (BlueCare) TennCare. For your convenience, we've put these commonly used documents together in one place. We've provided the following resources to help you understand Empire's prior authorization process and obtain authorization for your patients when it's . Fax medical prior authorization request forms to: 844-864-7853 Bundling Rationale (Claims filed before Aug. 25, 2017). * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. If you have questions regarding the list, please contact the dedicated FEP Customer Service team at 800-532-1537. Anthem does not require prior authorization for treatment of emergency medical conditions. These documents contain information about your benefits, network and coverage. Contact will be made by an insurance agent or insurance company. Sign up to receive personalized communication from us, and we'll refine it to meet your preferences. Or 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. Nov 1, 2021 0 CoverKids. This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. Please refer to the criteria listed below for genetic testing. Anthems PriorAuthorizationLookupToolOnlinecan assist with determining a codes prior authorization requirements. Providers are responsible for verifying prior authorization requirements before services are rendered. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Medicaid benefits to enrollees.

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