Ohio, Kentucky and Indiana managed care members of Anthem Blue Cross and Blue Shield (Anthem) will be able to see specialists without first receiving referrals from their primary care physicians beginning January 1, 2003. While the referral process will be eliminated, members in Anthem’s managed care plans will continue to select their primary physician from the network to assist them in coordinating their total health care. Primary Care physicians will assist Anthem by providing information to members and in helping administer Anthem’s Disease management programs, which provide more personalized information services to members with chronic diseases such as asthma, coronary artery disease and diabetes.
The no-referral provision will apply to members in Anthem’s Blue managed care plans, including Blue Preferred® Primary Plus (point-of-service); and Blue Preferred® Primary, Blue Priority® and Blue EMO® (health maintenance organization). The change does not apply to mental health services or to members in Anthem’s Medicare+Choice Plan and Anthem Senior Advantage. Members who are affected by this change will be notified.