COVID-19 News and Updates

COVID-19 Vaccine Administration Claims Submission Information (January 12, 2021)

This information is being provided to assist your pharmacy with submitting COVID-19 Vaccine Administration claims.

  • COVID-19 Vaccine Administration Claims Submission Information (January 12, 2021)
  • Information from Empire BlueCross BlueShield (Empire) for care providers about COVID-19 (Updated December 14, 2020)

    During these challenging times, Empire BlueCross BlueShield HealthPlus (Empire) is closely monitoring COVID-19 developments and what it means for our customers and our health care provider partners. We have taken actions to assist you and our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part.

    • Information from Empire BlueCross BlueShield (Empire) for care providers about COVID-19 (Updated December 14, 2020)
    • Billing instructions for COVID-19 tests in NCPDP D.0 format (August 21, 2020)

      When submitting to CVS Caremark* for COVID-19 test specimen collection, submit the appropriate quantity and the appropriate days’ supply. Inappropriate quantities or days’ supply may cause the claim to reject. Submit MA in the Professional Service Code Field (440-E5) of the DUR/PPS Segment along with a positive incentive fee amount in the Incentive Amount Submitted Field (438-E3) of the Pricing Segment when submitting for administering COVID-19 test.

      New York City’s COVID-19 Test & Trace Corps

      New York City has launched the Test & Trace Corps, an unprecedented effort to identify individuals who have COVID-19 or were recently exposed, and reduce the risk of disease transmission. New York City asks for your partnership in testing patients, educating them about isolation, informing them of NYC contact tracing activities, and helping to link them to supportive services.

      Mental health services cost share waiver expanded to Medicaid

      Empire BlueCross BlueShield (Empire) is closely monitoring COVID-19 developments and working to create solutions that address not just the physical toll of this crisis, but also the mental health needs in the state. As of May 2, 2020, Empire is waiving cost sharing for in-network outpatient mental health services for Empire members enrolled in Essential Plan, including essential workers.

      Listen now! Webinar recording available from Empire BlueCross BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19

      We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.

      Resources supporting our providers during COVID-19

      Supporting providers and those who deliver care to our members is our top concern during the COVID-19 health emergency. Navigating the rapidly changing information is especially important to us so you can focus on what’s important – patient care.

      Federal resources available for health care providers and employers in the federal CARES Act

      Anthem, Inc., the parent company of Empire BlueCross BlueShield HealthPlus, advocated for Congress to provide sufficient funding for hospitals to be able to address those in need of care, and we strongly support federal and state efforts to address the financial needs of care providers. To help care providers navigate the resources available to them, we compiled information on programs that could deliver additional financial relief during this crisis.

      Empire BlueCross BlueShield HealthPlus waives cost share for COVID-19 treatment

      Empire announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. The expansion covers the waiver of cost shares for COVID-19 treatment received through May 31, 2020.

      Patient cost-sharing for laboratory tests to diagnose COVID-19, provider visits to diagnose COVID-19 and all telehealth services

      Please be advised that the New York State Department of Financial Services (DFS), the New York State Department of Health (DOH) and the federal government are directing payers to waive patient copayments, coinsurance and deductibles for certain testing and treatment due to the COVID-19 emergency.

      SOMOS management of delegated functions postponed

      The collaborative partnership between Empire BlueCross BlueShield HealthPlus (Empire) and SOMOS IPA, LLC (SOMOS) and its affiliates previously set for March 1, 2020, has been postponed until further notice.