Anthem Blue Cross (Anthem) will work to facilitate the Continuity of Care/Transition of Care (COC/TOC) when Members, or their covered dependents with qualifying conditions, need assistance in transitioning to in-network Providers or Facilities. The goal of this process is to minimize service interruption and to assist in coordinating a safe transition of care.

This program is for Members when their Provider or Facility terminates from the network and new Members (meeting certain criteria) who have been participating in active treatment with a provider not within Anthem’s network.

Anthem will work to facilitate the Continuity of Care/Transition of Care (COC/TOC) when Members, or their covered dependents with qualifying conditions, need assistance in transitioning to in-network Providers or Facilities. The goal of this process is to minimize service interruption and to assist in coordinating a safe transition of care.

Members can call Anthem’s Member Services to request continuity/transition of care or for help with completing the form. 

 

For California members, fax the completed forms toll free:

  • Medical requests 1-877-214-1781.
  • Behavioral health requests - 1-877-521-4787
  • Applied behavior analysis services 1-866-582-2287.


Access the Continuity of Care/Transition of Care Request Form online.  The most current version includes an update to the definition of a maternal mental health condition - a mental health condition that can impact a woman during pregnancy, peri or postpartum, or that arises during pregnancy, in the peri or postpartum period, up to one year after delivery. For an individual who presents written documentation of being diagnosed with a maternal mental health condition from their treating health care provider, completion of covered services for the maternal mental health condition will be considered for a limited period of time, not to exceed 12 months from the diagnosis or from the end of the pregnancy, whichever occurs later.

 

Read about Anthem’s Continuity of Care/Transition of Care Program in the Facility and Professional Provider Manual.  The Manual is available online at anthem.com/ca > Providers > Provider Overview: Policies, Guidelines & Manuals, scroll down to Provider Manual on the left-hand side of the webpage.



Featured In:
March 2020 Anthem Blue Cross Provider News - California