ANTHEM BLUE CROSS PHARMACY CHANGES
CVS Specialty Pharmacy Update (07/01/2020) For questions, please contact your Provider Relations Representative or contact CVS Provider Services:
To help drive greater affordability for our clients and members, Anthem Blue Cross (Anthem) has partnered with CVS Specialty to fill some specialty medications for our members. As previously communicated, for dates of services on or after July 1, 2020, providers will be required to contact CVS Specialty’s Provider Services team to order medical specialty medications.
This communication is intended to further clarify this requirement applies to the attached list of specialty drugs, covered through the member’s medical benefits where Anthem has financial risk for the cost of specialty medications. This requirement does not apply to medications covered under a member’s pharmacy benefit.
The member’s medical group will continue to be responsible for UM and prior authorization of specialty medications. Providers should continue to submit for administration of the medication, but should not bill for the medication itself. CVS Specialty will bill us, and we will pay them directly. If a specialty medication on the attached list is obtained through another pharmacy, the claim will be denied.
Thank you for your continued participation in our networks and for your commitment to your patients.
Effective 08/01/2017 -- Added: CVS Pharmacy -- Participating Pharmacies;
Effective 08/01/2017 -- Removed: Rite Aid -- No Longer Participating;
CVS Specialty Provider Services Team Phone: 877-254-0015
Hours of Operation:
Mon-Fri 5:00 am - 7:30 pm Pacific
Sat 6:00 am - 10:00 am Pacific