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<p class="MsoNormal"><span style="mso-ligatures:none"><img width="193" height="64" id="_x0000_i1025" src="cid:image001.png@01DA4E9F.615F67E0"></span></p>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">January 24, 2024<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
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<span style="font-family:"Arial",sans-serif">To:<o:p></o:p></span></p>
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<span style="font-family:"Arial",sans-serif">Department Benefit Representatives<o:p></o:p></span></p>
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<span style="font-family:"Arial",sans-serif">From:<o:p></o:p></span></p>
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<span style="font-family:"Arial",sans-serif">Central HR Benefits Office on behalf of UC Office of the President<o:p></o:p></span></p>
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<span style="font-family:"Arial",sans-serif">Re:<o:p></o:p></span></p>
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<b><span style="font-family:"Arial",sans-serif;mso-ligatures:none">Anthem - 2024 OTC COVID Test Claim Submission Procedure</span></b><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-family:"Arial",sans-serif;color:black;mso-ligatures:none">___________________________________________________________________________________________ </span></b><span style="color:black;mso-ligatures:none"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><b><span style="font-family:"Arial",sans-serif">DBRs, please share this important information via your internal department listserv.<o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">UCOP was recently informed that due to programming issues at Anthem, participants should no longer use the Anthem.com portal or the Sydney app to submit 2024 Over-The-Counter (OTC) COVID test
claims. While the portal and the app still show the designated areas for submitting OTC COVID test claims, these areas are not operational and claims will not be processed correctly.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Plan members attempting to submit claims via the Anthem.com member portal or Sydney mobile app for any service date on or after January 1, 2024, should immediately receive an error message.
If a member filed the claim using the medical claims submission procedure, they will receive a denial after the claim has been processed. To prevent confusion, Anthem is working quickly to remove the OTC COVID test claim submission area from these applications.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Rather than using the Anthem.com portal or the Sydney app, members must
<b><u>mail</u></b> the </span><a href="https://www.anthem.com/docs/inline/24066CAMENABC-public.pdf"><span style="font-family:"Arial",sans-serif;color:#2E74B5">Anthem Medical Claim Form</span></a><span style="font-family:"Arial",sans-serif"> along with the receipts
for the OTC COVID test(s) to: <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Anthem Blue Cross<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">P.O. Box 60007<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Los Angeles, CA 90060-0007<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><b><span style="font-family:"Arial",sans-serif">Members need only complete Section 1 and Section 2 of the claim form along with their signature.
</span></b><span style="font-family:"Arial",sans-serif"> Claims processing may take 45 days. Any questions may be directed to the Accolade Health Care Advocate at
<b>1-866-406-1182</b> (Monday to Friday, 5:00 AM until 8:00 PM, Pacific Time). <o:p>
</o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">The Accolade and Navitus front-line service teams have been updated with this information. Callers will be provided instructions on how to submit OTC COVID test claims to Anthem through the
mail. <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><b><span style="font-family:"Arial",sans-serif">Note:</span></b><span style="font-family:"Arial",sans-serif"> For the UC non-Medicare PPO Plans, claims for OTC COVID test kits will be reimbursed at 100% before deductible for up to 8 tests
per enrolled member per month. </span></p>
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