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Point of Care

PW_E169315
Important notice regarding upcoming changes impacting Point of Care 
Effective December 12, 2014, access to Eligibility, Benefits and Claim Status Inquiry will be available only at www.availity.com. In addition, Secure Messaging functionality on Availity will replace the electronic 151 inquiry. All access is still available to Medical Management Functionality, Reports including remittances and access to prior electronic 151s which are currently on Point of Care. However, access to these functions will need to be via single sign on through Availity. Direct access to Point of Care will no longer be available after December 12, 2014. If you do not have an Availity log-in, your organization’s Availity Primary Access Administrator can register you and complete the Anthem Services Registration on Availity to connect your Point of Care and Availity accounts. If you have any questions, please contact Availity Client Services toll free at 1-800-282-4548 or via email at virginiapocmigration@availity.com for assistance.  
Please note: Electronic transactions submitted via Provider Self Service (PSS) - the secure provider website for Anthem HealthKeepers Plus (Medicaid) - are unaffected at this time. 
Point of Care 
Anthem Point of Care is a free service provided by Anthem to our participating providers. Here is a list of just some of the features and information that can be made available to you when you register for Point of Care:  
Claims Status
View a comprehensive list of policy members having claims on file and individual claim data in detail.  
Eligibility
Retrieve eligibility information for PAR, PPO, POS, HMO and Medicaid HMO policyholders. Providers may also request eligibility data on patients covered through the Federal Employee Program and the BlueCard® Program.  
Benefits
Review in detail benefits available for a patient, including copay and deductible information.  
Medical Management
Primary Care Physicians can submit referrals (specialty care reviews) and fax referral information to specialists and hospitals.
Hospitals and specialists can view referrals for their patients.
Hospitals and admitting physicians can submit requests for admission reviews.
Utilization Review/Case Management Departments and attending physicians can update clinical information and ask for extension of hospital stays.
View authorizations of outpatient procedures (health services reviews).
Providers can determine whether or not a prior authorization (health services review) is required for an outpatient procedure.
 
151 Forms
Submit a 151 adjustment request form electronically and receive an answer within five to 10 business days.  
Provider Reports
View Weekly Payment Vouchers, PCP Member Reports, Error Notifications and other relevant reports.  
And More…
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use