#Blue cross anthem california professional

Some Blue Cross members will continue to access Dignity Health services for a limited time. Also, out-of-network are Dignity Health Medical Foundation physicians and hospital-based clinics for commercial PPO, EPO health plans, Medicare Advantage and Workers Comp. Anthem Blue Cross has been oddly quiet on the excommunication that affects thousands of individuals and families across California.Īnthem Blue Cross health plans affected by the Dignity Health schism are Dignity hospitals for commercial HMO, EPO, PPO, and POS health plans, some Medicare Advantage plans, Medi-Cal HMO, Workers Comp plans. However, Dignity paints Anthem Blue Cross as intransigent in accepting some higher reimbursement costs for health care services. Dignity Health Starts To Terminate Anthem Blue CrossĬommunication from Dignity Health states they are presenting solutions to the contract impasse. Because Blue Cross EPO plans – which includes Covered California – serve much of rural Northern California, it may be a challenge to find another doctor in parts of California if Dignity Medical Group doctors are not available. The disruption to Dignity Health patients with Blue Cross insurance is even worse if the patient is undergoing treatment for an illness. Travel Health & Medical Insurance Plansįor Blue Cross members in EPO plans, that have no out-of-network coverage, this poses a particular challenge.Covered California Enrollment & Eligibility Support Documents.

This APL confirmed that the prior APLs ( 20-009 and 20-013) remain in effect for the duration of California’s declared state of emergency or until further notice from DMHC, whichever is earlier.įor specific details about Anthem’s reimbursement policies, visit the /ca website. The clarification issued by Anthem aligns with the DMHC all plan letter (APL) issued on September 4, 2020, which reminded DMHC-regulated health plans of the continued requirement to reimburse providers at the same rate for telehealth services, including telephonic visits, as they would for services provided in person. Anthem agreed that this was an error and has issued a clarification notice. Because this new policy does not align with California’s telehealth parity requirements, the California Medical Association (CMA) asked Anthem to clarify whether the new policy applies to California physicians.

#Blue cross anthem california professional

In its December 2021 Anthem Provider News, Anthem Blue Cross announced a reimbursement policy update, “Virtual Visits – professional and facility,” which indicated that telehealth services billed with place of service (POS) 02 (telehealth provided other than in patient’s home) or new POS 10 (telehealth provided in patient’s home) would be reimbursed at the non-office place of service rate. Anthem Blue Cross has clarified that for California providers, it will continue to reimburse telehealth services billed with either POS 02 or POS 10 at the in-office place of service rate, as currently required by the California Department of Managed Health Care (DMHC).