Select a State Provider Forms & Guides Easily find and download forms, guides, and other related documentation that you need to do business with Anthem all in one convenient location! You dont need a referral from your PCP for eye care benefits. Visit our COVID-19 Resource Center for more information. Anthem members in Nevada receive routine vision services through EyeQuest. Get the mobile app
For some services, youll need a referral from your primary care provider (PCP) before getting care. We cover a wide range of prescription drugs and over-the-counter medicines. Return the form to Nevada Medicaid, Attn: MCO Changes, P.O. You can also call the Division of Welfare and Supportive Services: Northern Nevada: 775-684-7200 Southern Nevada: 702-486-1646 Toll Free: 1-800-992-0900 Or use the portal and sign up . 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., 2023. At Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem), we value you as a provider in our network. Dont wait until your next sick day. 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. We currently don't offer resources in your area, but you can select an option below to see information for that state. Be prepared with the knowledge to assist our members. Enroll Renew We look forward to working with you to provide quality services to our members. That's why we've redesigned the provider site to make it more useful for you and easier to use. Your benefits include eye exams once every 12 months. As part of the Carelon guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable . Email a Provider Relationship Management associate. The table below shows the regularly scheduled maintenance window. We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities. %%EOF
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<. hb```"kVma10p`P]Ea('ci8J2=Yb.e@3":QH5 u1B@ Our 24/7 NurseLine is a resource you call when life throws you a curve ball: 1-800-600-4441 (TTY 711). We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. (TTY 1-800-466-7566) or go to the EyeQuest website. 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. Division of Health Care Financing and Policy Portal, Nevada Department of
Your Provider Relationship Management will respond usually within two business days. Interested in joining our provider network? Access resources to help health care professionals do what they do bestcare for our members. See Web Announcement 1265, Enrollment Termination Frequently Asked Questions (FAQs) [Review]. Medicaid Member News: Nevada Medicaid sends notifications over ListServ direct to your email regarding news, initiatives and public meetings. For details on open enrollment, contact your local Medicaid District Office at the following numbers: Northern Nevada (775) 687-1900 or Southern Nevada (702) 668-4200. Members can call EyeQuest at 1-800-787-3157
You must be enrolled in the Healthy Rewards program to earn rewards for your healthy activities. AIM ProviderPortal SM com: Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization. Thats why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program, which is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns. Provider education and training You can get more information about the providers in our health plan. Visit docinfo.org to search for providers and find out where they went to medical school. Type at least three letters and we will start finding suggestions for you. Weve been helping Nevada families get and stay healthy since 2009. The resources for our providers may differ between states. Call our 24/7 Behavioral Health Crisis Line at 1-844-396-2331. Choose your location to get started. Please note the daycare and gestational diabetes pregnancy meal benefits start on October 1, 2022. Our qualified mental health professionals provide counseling and crisis intervention as needed. 2021copyright of Anthem Insurance Companies, Inc. 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. During the scheduled site maintenance window the Provider Web Portal will be unavailable. Medicare, Individual & Family, and Employer Group Plans Medicaid Forgot Username or Password? State Partners Members Medicaid Members Low-cost coverage for children, adults and families Choose your state Medicare-Medicaid Plans (MMP) Members Combined Medicare and Medicaid coverage for eligible adults over 21 Choose your state Updates and reminders Coronavirus (COVID-19) But there are some services that well pay for, even if you get them from a provider whos not in our network. To get Nevada Medicaid benefits through Anthem, you must have limited income and live in one of our service areas. For details on open enrollment, contact your local Medicaid District Office at the following numbers: Northern Nevada (775) 687-1900 or Southern Nevada (702) 668-4200. Choose your location to get started. 6
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1-844-396-2329 (TTY 711). As communicated in the April Provider Newsletter, effective August 1, 2023, Carelon Medical Benefits Management, Inc.* (formerly AIM Specialty Health [AIM]) will expand multiple Carelon programs to perform medical necessity reviews for additional procedures for Anthem Blue Cross and Blue Shield (Anthem) members.. 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. A Guide to Improving the Patient Experience, A Guide to Screening, Brief Intervention, and Referral to Treatment, Early and Periodic Screening, Diagnostic and Treatment. Sign up today. LiveHealth Online Visit a doctor 24/7 through live video using LiveHealth Online. Anthem Blue Cross and Blue Shield Healthcare Solutions provides all your Nevada Medicaid benefits, like care from a PCP you choose, pharmacy benefits, preventive care and more all at no cost to you. All services billed with the following revenue codes: Related information Precertification lookup tool All you need is your smartphone, tablet, or computer. We are here to help. You can also visit bcbs.com to find resources for other states. The expansion will require clinical appropriateness review for additional procedures related . Your browser is not supported. Annual sports physical from an Anthem PCP for members ages 6-18. Anthem Blue Cross and Blue Shield Healthcare Solutions provides all your Nevada Medicaid benefits, like care from a PCP you choose, pharmacy benefits, preventive care and more all at no cost to you. 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. Pharmacy Check our Preferred Drug List Services billed with the following revenue codes always require prior authorization: The following always require precertification: Elective services provided by or arranged at nonparticipating facilities. Read it to find out about: Call Member Services at 1-844-396-2329 (TTY 711). The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, May 21, 2023, for scheduled maintenance: Secure Provider Web Portal (Electronic Verification System - EVS) Online Provider Enrollment (OPE) Online Provider Claim Appeals Online Prior Authorization (PA) system You can earn gift cards for a variety of retailers by completing activities such as wellness checkups, diabetic screenings, mammograms, refilling your medication, etc. Welcome, providers! All times will be in the Pacific time zone. Nevada Medicaid members under 21 also get eyeglasses or contact lenses (if medically necessary). It tells you how you can get the most from your benefits. Maintaining good health is important. Save Time With Live Chat Get translation and interpretation services free of charge. Anthem Blue Cross and Blue Shield and our subsidiary company, HMO Nevada (hereinafter collectively referred to as "Anthem") has added new functionality to Nevada provider enrollment tool hosted on the Availity Portal to further automate and improve your online enrollment . Monday - Friday
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Resources are here that help health care professionals do what they do best care for our members. To learn more and enroll, visit the Benefit Reward Hubor call the Healthy Rewards Customer Service line at 888-990-8681 (TTY 711) Monday through Friday from 6 a.m. to 5 p.m. Pacific time. 2021copyright of Anthem Insurance Companies, Inc. 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. Medicare Advantage Itemized bill review program Prior authorization requirement changes effective August 1, 2023 in Nevada Medical Policies and Clinical Utilization Management Guidelines update Administrative / Digital Tools | Commercial / Medicare Advantage / Medicaid | May 2, 2023 Type at least three letters and we will start finding suggestions for you. Practice Profile Update Form
You can access the Precertification Lookup Tool through the Availity Portal. Please do not complete the form if you know that your address is up to date. Anthem is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email. For help finding a plan eye doctor, call EyeQuest toll free at 1-888-300-9025
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. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
You can also visit. Youll need a referral from your PCP before: For most services, youll go to your PCP or another provider in our network. This number is also on the back of your ID card. On July 6, 2015, Nevada Medicaid completed updating all of the Nevada Medicaid forms that are available on this website. Were here if you or a family member needs help. Medicare: https://www.anthem.com/medicareprovider Medicaid: https://providers.anthem.com/nevada-provider/home Availity Portal:* https://www.availity.com Availity Client Services: 1-800-AVAILITY (1-800-282-4548) Commercial/Medicare/Medicaid There are an array of valuable online tools through the Availity Portal, a secure multi-health plan portal. 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. Its an easy way to get care for you or your family anytime of the day or night without leaving home. Select a State Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Click here to see the State of Nevada Online Privacy Policy, Nevada Medicaid And Nevada Check Up Managed Care Program Special MCO Assignment Change, https://dhcfp.nv.gov/Resources/NevadaMedicaidUpdate/MemberNewsListserv/, https://dhcfp.nv.gov/Members/BLU/MCOMain/, Click here to see the State of Nevada Online Privacy Policy. Be sure to take the referral form with you when you go to the specialist. Please update your browser if the service fails to run our website. We have doctors, therapists and counselors to help you with your behavioral health needs. Division of Health Care Financing and Policy Portal, Nevada Department of
We created this short video to show you how. 1-844-396-2329 (TTY 711). 8:00PM - 12:00AM. Your dashboard may experience future loading problems if not resolved. He or she can be a doctor, a nurse practitioner or a physicians assistant. AIM Specialty Health (AIM)* has a new phone number for Anthem Blue Cross and Blue Shield Healthcare Solutions providers in Nevada to use to submit prior authorization requests. The referral form tells you and the specialist what kind of health care you need. For more information, visit Healthy Rewards on theBenefit Reward Hub or call the Healthy Rewards Customer Service Line at 888-990-8681 (TTY 711) Monday through Friday from 6 a.m. to 5 p.m. Pacific time. The resources for our providers may differ between states. Sign up today. View the extra benefits youre eligible for on the Benefit Reward Hub or call Member Services at 844-396-2329 (TTY 711) Monday through Friday from 7 a.m. to 7 p.m. Pacific time. We put tools and technologies in your hands to make it easier to access care and services. Anthem has a large network of doctors and nurses who help our members. The following form is for the use of Nevada Medicaid providers to certify the recipient has received prenatal/antepartum and/or oral health care . You dont need a referral for vision care. . Through this easy-to-use internet portal, healthcare providers have access to useful information and tools regarding provider enrollment and revalidation, recipient eligibility, verification, prior authorization, billing instructions, pharmacy news and training opportunities. Our text-based peer support services program provides peer-led crisis services to members age 13 and older via text. Keep in mind, if you dont renew before the deadline, you may have a gap in health coverage. How often do you get rewarded for doing something good for your health? You can redeem some benefits online through your secure account. 12:00AM - 12:30AM, Monday
"WHs ]&$dVV"l]`' You can search by provider name, city and state, or specialty. All times will be in the Pacific time zone. You can also visit bcbs.com to find resources for other states. Urgent Care. The Nevada Division of Health Care Financing adheres to all applicable privacy policies and standards, including HIPAA rules and regulations, regarding protected health information. CDT is a registered trademark of the ADA. You can also view the Nevada Medicaid Response to members and providers on the Novel Coronavirus (COVID-19)or visit theNevada Health Response website. Nevada Medicaid and Nevada Check Up members should ensure their contact information is up to date. Your dashboard may experience future loading problems if not resolved. Effective January 1, 2021, Electrical Workers Local 357 in Nevada will offer a Medicare Preferred (PPO) plan from Anthem. No longer qualify for Medicaid? The MCOs include: Anthem Blue Cross Blue Shield Healthcare Solutions o https://mediproviders.anthem.com/nv/Pages/home.aspx o (844) 396-2330 Health Plan of Nevada o www.myhpnmedicaid.com/Provider o (800) 745-7065 Molina Healthcare of Nevada o www.molinahealthcare.com/members/nv/en-us/health-care-professionals/home.aspx o (833) 685. Effective January 1, 2022, Medicaid enrollees may be switched to one of four MCOs. For other issues, you can message the Provider Relationship Management team. If your state isn't listed, check out bcbs.com to find coverage in your area. We currently don't offer resources in your area, but you can select an option below to see information for that state. 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., 2023. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. If you have questions or need assistance, please contact your Provider Relations representative or contact Provider Services: Fraud, waste and abuse referrals can be made through the following avenues: If you need to update your provider demographic information, please complete the
ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. Medical Oncology Program ProviderPortal case entry enhancements On March 26, 2023, Carelon Medical Benefits Management Inc. (formerly AIM Specialty Health)* released operational enhancements to the ProviderPortalSM for the Medical Oncology Program for Anthem Blue Cross and Blue Shield. We created this short video to show you how. 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., 2023. hbbd```b`` The notifications and web announcements keep providers updated on enhancements to the online tools, as well as updates and reminders on policy changes and billing procedures. Effective for dates of service on and after September 10, 2023, the following updates will apply to the Carelon Medical Benefits Management, Inc.* (formerly AIM Specialty Health ) Clinical Appropriateness Guidelines listed below. Healthy Rewards is a program that pays you for taking control of your health. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Stay informed activate your online account, Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish). Please use 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. Call Member Services at
Begin Application Launch Availity Find Forms Review Policies Contact Us Important Announcements Training opportunities Everyone struggles at times, and everyday problems can lead to depression, anxiety, and alcohol or drug abuse. Learn more about behavioral health resources. %PDF-1.6
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With Anthem, you go to one main person for your health care. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Support Sections Forms A Guide to Improving the Patient Experience, A Guide to Screening, Brief Intervention, and Referral to Treatment, Early and Periodic Screening, Diagnostic and Treatment. Nevada Medicaid and Nevada Check Up contracted Managed Care Organizations (MCOs) Contact Information: The Nevada Medicaid and Nevada Check Up contracted Managed Care Organizations (MCOs) are Anthem Blue Cross and Blue Shield Healthcare Solutions, Health Plan of Nevada, Molina Healthcare of Nevada and SilverSummit Healthplan. You can get more information about the providers in our health plan. The resources on this page are specific to your state. When your PCP is unable to give you care or treatment, he or she may send you to another provider, such as a specialist. See Web Announcement 1265, Enrollment Termination Frequently Asked Questions (FAQs) [Review]. The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer. LIBERTY Dental Plan of Nevada is the Dental Benefits Administrator (DBA). If you need to change your assigned MCO, complete the Nevada Medicaid And Nevada Check Up Managed Care Program Special MCO Assignment Change form. Get translation and interpretation services free of charge. Get the mobile app
We can connect you to a plan that's right for you. It looks like you're outside the United States. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) has an online tool that displays prior authorization guidelines to help you quickly determine whether certain services for Anthem members require a prior authorization. Use your Anthem identification (ID) number to log in to their website. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
He or she may tell you to come into the office right away, go to an urgent care center, or go to the ER. Annual Boys & Girls Club memberships for members ages 5-14. Your browser is not supported. Through this easy-to-use internet portal, healthcare providers have access to useful information and tools regarding provider enrollment and revalidation, recipient eligibility, verification, prior authorization, billing instructions, pharmacy news and training opportunities. The new phone number is listed below and will go into effect on April 1, 2022. Free cellphone with free monthly minutes, data and text messages. Lets make healthy happen, 2021Anthem Insurance Companies, Inc., Privacy Guidance When Selecting Third-Party Apps (English), Privacy Guidance When Selecting Third-Party Apps (Spanish), Going to a hospital for non-emergency care, Care provided by your Anthem network PCPs nurse or doctors assistant, Eye exams from an Anthem network eye care provider (optometrist), Family planning services from any qualified family planning provider, Healthy Kids visits to an Anthem network provider, Prenatal care from an Anthem network obstetrician or certified nurse-midwife, Yearly exams from an Anthem network OB/GYN. Sydney Health is accessible for members who use the Engage Wellbeing app, but features are limited. Visit the Pharmacy page to find a pharmacy near you and check if your medicine is covered. It looks like you're in . For childless adults ages
ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
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