Policy UpdatesCommercialMedicare AdvantageMay 1, 2023

Providers conducting eConsults: more patients’ care eligible for payment

This communication applies to Commercial and Medicare Advantage plans from Anthem Blue Cross (Anthem) in California.

California providers using eConsult vendor AristaMD* no longer need to pay for eConsults conducted for Anthem patients on Medicare Advantage or Commercial health plans.

Effective February 1, 2023, Anthem will pay AristaMD on behalf of providers for eConsults for Commercial and Medicare Advantage members. Medicaid members with Anthem were already covered for eConsult services.

Electronic physician consults, or eConsults, are a way for primary care providers to request medical specialists’ assistance prior to referring a patient for in-person specialty care. Using eConsults can expand access to specialty expertise while minimizing unnecessary in-person specialist visits and wait time to see a specialist in person.

AristaMD is one of several vendors offering a specialist network and platform for transmitting and billing eConsults. They are an independent company providing services for Anthem network providers and their patients along with other health plans.

To learn more about eConsults and AristaMD, visit their website at aristamd.com.

* AristaMD is an independent company providing digital care services on behalf of the health plan.

Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: May 2023 Provider News