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How to access telehealth benefits and verify copay in PEAR

For Independence Blue Cross members and AmeriHealth New Jersey members only

Confused about members’ telehealth benefits for behavioral health services through Magellan? Here’s what you need to know about the local versus out-of-area benefits for members of Independence Blue Cross and AmeriHealth New Jersey plans:

Local members receiving behavioral health services via telehealth

Important note: The Telemedicine section of PEAR PM does NOT pertain to local members’ behavioral health benefits.* 

Local members, who have Magellan as their behavioral health vendor, are eligible for all applicable telehealth services from Magellan providers. (This is not stated in PEAR Practice Management [PM] since receiving telehealth services from Magellan is a health plan policy, and policies are not addressed in PEAR PM.)

Magellan providers may perform all applicable behavioral health services via telehealth for local members.

How to find telehealth copay information

Go to the PEAR portal. Select the Eligibility & Benefits transaction in PEAR PM. Search for the member using the E&B transaction. Select Behavioral Health/Substance Abuse from the Benefits & Coverages tab. Find the copay amount listed in this section. If a single copay line exists, the in-office copay and virtual services (telehealth) copay is the same. If the telehealth copay is different than the in-office amount, you will see a second copay line.

In the example above, the second line specifically states, “Copay for Virtual Services.” This line will state either a different copay amount, or it will state “No,” meaning the copay for virtual services (telehealth) is waived. If there is no second line, the copay for in-office and virtual services is the same.

Questions?

• Contact Independence Blue Cross Provider Services at 1-800-ASK-BLUE (1-800-275-2583).
• Contact AmeriHealth New Jersey Provider Services at 1-888-YOUR-AH1 (1-888-968-7241).

*The Telemedicine section of PEAR PM pertains to behavioral health benefits for national Independence Blue Cross and AmeriHealth New Jersey members who are located outside the health plan’s service area. The language in the Telemedicine section indicates that MDLIVE^® is the sole vendor for behavioral health. This statement applies to out-of-area members only; it does NOT apply to local members who have Magellan as their behavioral health vendor.