Community Supports Billing Guidance for Anthem MediBlue Full Dual Special Needs Plan

The purpose of this bulletin is to provide guidance on billing claims specific to Anthem members enrolled in the in the Exclusively Aligned Dual Specials Needs Plan (EAE D-SNP), also known as Anthem MediBlue Full Dual Advantage (through December 2023) and Anthem Full Dual Advantage Aligned plan (starting January 1, 2024), for Community Supports (CS), Long-Term Care (LTC) in Skilled Nursing Facilities (SNF), and Community Based Adult Services (CBAS)

The Anthem MediBlue Full Dual Advantage plan is an exclusively aligned enrollment dual special needs program that integrates the member’s Medicare Advantage and Medi-Cal Managed Care (Medi-Cal) care coordination, benefits, and services under one plan. This plan is currently in Santa Clara and Los Angeles counties only.

This plan will be expanding to Fresno, Kings, Sacramento, Madera, and Tulare starting in January 2024.

Effective January 1, 2024, Anthem MediBlue Full Dual Advantage plan name is changing in all counties to Anthem Full Dual Advantage Aligned. This does not affect eligibility for benefits and services.

For providers that use the Automated Eligibility Verification System (AEVS), the name of the dual plan will not populate, but will display Anthem Dual Advantage. If Anthem Dual Advantage is displayed, you must check Availity to determine if the member is an Anthem MediBlue Full Dual Advantage (through December 2023) or an Anthem Full Dual Advantage Aligned member (starting January 1, 2024).

Member ID

Under this plan, Anthem issues members one ID card for Medicare Advantage and Medi-Cal services. The Medi-Cal offices in each county also issue a Medi-Cal or Benefits Identification (BIC) card.

The member ID on the Anthem issued card is necessary to file your CS claims. Utilizing the Medi-Cal or the original Medicare Advantage ID will result in claims being rejected.

Please ensure that the member ID listed on the claim matches the member ID on the approved authorization for services.

How to bill Anthem MediBlue Full Dual Advantage plan members:

• Use members unique ID:
  • For example: MNL123W12345
  • Can be found by:
    • Member insurance card
    • Phone at: 833-707-3129
    • Online at: https://tinyurl.com/ycxu4psd

Customer Care Centers:

• Medi-Cal Managed Care (outside L.A. County): 1-800-407-4627
• Medi-Cal Managed Care (inside L.A. County): 1-888-285-7801