AdministrativeCommercialOctober 1, 2021

Guided Access HMO plans overview

As a reminder, Anthem Blue Cross and Blue Shield and our subsidiary company, HMO Nevada (Anthem) have products called Guided Access HMO. We would like to share information regarding these plans to help ensure our providers have as much information as possible to assist in servicing members with one of these plans.

 

Guided Access HMO plans may be accessing a different network depending on the Health Benefit plan option.

  • Large Group/Small Group members will utilize the HMO Nevada network
  • Individual Exchange members will utilize the Pathway X HMO network

 

Referral requirements

Guided Access HMO plans both require a Primary Medical Group selection and Primary Care Physician (PCP) referral to specialists.  Submit referral requests should through Availity via the Interactive Care Reviewer (ICR) online referral tool.

 

Sample Guided Access HMO ID card

Please note the ID cards below are just samples, and do not include actual member information such as copays. That information will be included when the ID cards are generated and sent to members prior to the effective date



Summary of Information

 

Additional Details:

Contact your local Anthem network consultant for additional details regarding:

  • Operational Procedures
  • Referrals for Guided Access HMO
  • Submit a Referral via Interactive Care Reviewer (ICR).


Anthem is dedicated to providing excellent customer service for Guided Access HMO members and their providers. We look forward to building a successful relationship. We appreciate this opportunity to assist you.

 

1336-1021-PN-NV