Virginia Accredited Office Surgery Program and upcoming program amendment

Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. offers surgeons and certified nurse midwives the opportunity to participate in our Accredited Office Surgery Program. For providers not familiar with this program, it provides safe and effective surgical care at significant cost savings for members and the health plan. The surgical procedures are selected based on CMS standards of safety in an outpatient setting, and the surgical offices are accredited by one of four national accrediting bodies.

For referring providers, please keep this program in mind for your patients as most of your patients who are Anthem members will have a significantly lower cost share for these services compared to the same surgical procedure rendered in a facility. Additionally, for surgical provider groups not currently participating in the Accredited Office Surgery Program but interested in enrolling, please reach out to your network manager.

Anthem will notify provider groups who currently participate in our Accredited Office Surgery Program by email regarding an amendment to the program, which includes Commercial and Medicaid network fee schedule updates, as well as adding additional surgical procedures. The amendment will take effect on July 1, 2024.

Accredited Office Surgery Program for Medicare Advantage members

For existing Accredited Office Surgery Program providers, we will be offering this program for our Medicare Advantage members for the first time. To enroll in the Medicare Advantage Accredited Office Surgery Program, you must participate with our Medicare Advantage network. A separate signature is also required to enroll your accredited office into the program. Your practice will receive emails on or shortly after April 26, 2024, at which time you may also log into Availity to securely access and download a digital copy of your amendment documents using the Provider Online Reporting (POR) tool. You will need to open, sign, and return the executed Signature Page directly to your network manager.

If you have questions, please contact your Anthem network manager by visiting anthem.com and following these steps: Select For Providers, select Contact Us under Communications, change the state to Virginia, and choose the appropriate Physician Provider Network Managers Contact List.

As a reminder, periodically log into POR to ensure you don’t miss any notifications for your review. Keep in mind that only authorized users in your practice or facility can view the confidential contract amendments using POR. Your Availity administrator must grant access to POR if you do not currently have access. For easy reference, we’re including information to help you get started with provider contract and fee schedule notifications, if needed.

Provider Online Reporting Reference Guide

How to get started

This document will familiarize you with the POR application found at Availity.com. You can access your updated fee schedule on POR.

For Availity Administrators: How to assign access

If your organization is not currently registered for Availity, go to Availity.com and select Register to complete the online application.

Your Administrator will need to take the following steps to assign access to POR:

1. Assign the user role of POR to user’s Availity access.
2. Select Payer Spaces in the top menu bar and select the payer tile that corresponds to the market.
3. First-time users accessing Payer Spaces will be asked to accept a Terms of Use Agreement. The agreement will appear for users once every 365 days.
4. On the Applications tab, select Provider Online Reporting.
5. Select an organization and select Submit.
6. On the Welcome to Provider Online Reporting page, select Register/Maintain Organization.
7. Select Register Tax ID(s) for the applicable program to register the tax IDs.
8. A pop-up window will display all tax IDs that need to be registered for the program. Check the box for each tax ID to be registered and select Save.
9. The tax ID registration has been successfully completed. Notice that after the registration has been completed, the status has changed from Register Tax ID(s) to Edit Tax ID(s).

For Users: How to navigate to the report

Accessing reports:

1. Log in to Availity.com.
2. Choose Payer Spaces in the top menu bar.
3. Select the payer tile that corresponds to your market.
4. Accept the User Agreement (once every 365 days).
5. On the Applications tab, select Provider Online Reporting.
6. Select organization and choose Submit.
7. Select Report Search, choose the type of report, and then launch your program’s reporting application.
• The home page in Provider Online Reporting will open. This page lists all programs for which that organization is eligible. Use the navigation options on the left-hand side of the page to easily move around within the tool.
• The Programs page provides a description about the program your organization is participating in and includes helpful documents related to your program if applicable. Select a program using the drop-down arrow.
• The Report Search page launches the corresponding reporting application to your program. Select the appropriate program from the drop-down menu.

Helpful tip: Save online Provider Online Reporting as a favorite to be able to access it quickly from the Availity home page:

1. Log in to Availity.com.
2. Choose Payer Spaces in the top menu bar.
3. Select the payer tile that corresponds to your market.
4. On the Applications tab, select the heart icon next to Provider Online Reporting so it fills in and turns red.
5. Now Provider Online Reporting will appear at the top under the My Favorites drop-down.

Questions

• Regarding Availity, contact Availity Client Services at 800-282-4548.
• About POR, use the Contact Us section of the application.
• If you have other questions, contact your local contract advisor, consultant, or provider relationship management representative.