As a contracted provider with Anthem Blue Cross and Blue Shield (Anthem) in Indiana, Kentucky, Missouri, Ohio and/or Wisconsin, please remember that you are obligated when medically appropriate to refer Anthem members to in-network providers.  This includes physicians and all provider types including, but not limited to, ambulance transport (ground and air), ambulatory surgical centers, behavioral health services, physical medicine providers and ancillary providers.  Referring to in-network providers allows members to receive the highest level of benefits under their Health Benefit Plan.  As a reminder, call Anthem first for pre-certification if required by the member’s policy.

 

Ground Ambulance Providers

You can search for participating ground providers using our online tool, Provider Finder, located at www.anthem.com. Search parameters include distance from your location (zip code, address or county). To use the tool, go to www.anthem.com and follow these steps in our “Find a Doctor” tool:

 

  1. Select “all plans/networks”
  2. Select type of coverage
  3. I am looking for a: “other medical services”
  4. Who specializes in: “ambulance companies”
  5. Located near: add your address, zip or county

 

Air Ambulance Providers

Attached is the list of particlpating air ambulance providers with Anthem in Indiana, Kentucky, Missouri, Ohio and/or Wisconsin. This means that these providers have contractually agreed to accept the Anthem Rate as payment in full for covered services, and they will bill members only for allowable benefit cost-share obligations when transporting members who are picked up in your state. 

 

Some air ambulance providers choose not to participate with payers like Anthem. 

  • These air ambulance providers may charge member rates that are much higher than the Anthem contracted provider rates.
  • Depending on their benefits, members who utilize non-participating air ambulance providers can be left with significant out-of-pocket expenses, which the ambulance providers and their billing agents may seek to collect.

 

To avoid these situations, we ask that, whenever possible, you use a participating air ambulance provider for your patients who are our members.  Utilizing participating providers:  

  • Protects the member from balance billing for what may be excessive amounts,
  • Assures the most economical use of the member’s benefits, and
  • Is consistent with your contractual obligations to refer to in-network providers where available.

 

To schedule fixed wing or rotary wing air ambulance services, please contact Anthem for pre-certification if required by the member’s policy, then call one of the phone numbers listed below. Please have the following information ready when you call:

  • Basic medical information about the patient, including the patient’s name and date of birth or age. If the service was not pre-certified with Anthem, the air ambulance provider will also need to receive a full medical report from the attending facility.
  • Current location of the patient, the name of the hospital or facility caring for the patient and its address (city and state).
  • Location where patient is to be transported, including the name of the destination hospital/facility and address.
  • Approximate transport date or time frame.
  • Special equipment or care needs.

 

Should you have questions regarding the air ambulance network, including providers contracted for air ambulance pickups outside of your state, please contact your Provider Network Manager.  To arrange air transport originating outside the U.S., U.S. Virgin Islands and Puerto Rico, call 800-810-BLUE for BCBS Global Core (formerly Bluecard Wordwide).



Featured In:
May 2019 Anthem Provider Newsletter - Missouri