CurrentBlue Cross Blue Shield - NevadaPolicy N/A

Continuation of Care Form / Continuation of Care for members from non-contracted providers

This administrative form governs requests for continuity/transition of care when a provider is no longer contracted with Anthem Blue Cross and Blue Shield and affects members receiving active treatment (including prenatal care, acute or chronic treatment) who wish to continue with an out-of-network provider.

Policy Summary

PayerBlue Cross Blue Shield - Nevada

PolicyContinuation of Care Form / Continuation of Care for members from non-contracted providers

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the completed Continuation of Care Form (Form#1685B) to Anthem Medical Management by mail or fax to request approval for ongoing visits with a provider who left the network.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

up to 90 daysduration visits may be approved for active treatment

2nd/3rd trimesterprenatal care eligible for continuation

Form#1685Bform identifier

877-539-3851submission fax

Continuation / Transitional Care Approval Criteria

Continuation/Transitional Care approval criteria

Criteria for approving continuation/transition of care requests submitted via the form:

Member is a new member receiving prenatal care or is in active treatment for an acute or chronic condition with a provider who left the Anthem BCBS network.

Member or authorized person completes and submits the Continuation of Care Form (Form#1685B) to Anthem Medical Management by mail or fax.

ALL of the following

Visit approval timeframe (ANY of the following):
- Visits approved through the current period of active treatment.

Policy Summary

PayerBlue Cross Blue Shield - Nevada

PolicyContinuation of Care Form / Continuation of Care for members from non-contracted providers

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the completed Continuation of Care Form (Form#1685B) to Anthem Medical Management by mail or fax to request approval for ongoing visits with a provider who left the network.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

How to Request Continuation of Care

Note

Continuation of Care request procedure

Continuation of Care Form (To be used when a provider is no longer contracted with Anthem BCBS Network). Our goal is to provide benefits for continuity of care for any new member of Anthem Blue Cross and Blue Shield who is receiving prenatal care or is in active treatment for an acute or chronic condition with a provider who has left the Anthem Blue Cross and Blue Shield Network. Visits through the current period of active treatment or up to 90 days, depending on the care needs and circumstances, will be approved. If the member chooses to continue prenatal care with an out-of-network provider, visits may be approved if the member is receiving prenatal care during the second or third trimester and will continue through post‑partum care directly related to the delivery. If you or any covered family member are receiving care of this kind from a non‑participating provider, please complete this form. Information provided will be kept confidential by Anthem Blue Cross and Blue Shield and used in accordance with applicable privacy laws. Anthem Blue Cross and Blue Shield may share this information with your primary care provider (PCP) and/or specialist and may contact you to facilitate continuity or continuation of care.

Use this Continuation of Care form to request approval for ongoing visits with a provider who left the Anthem BCBS network.
Approved duration: through the current period of active treatment or up to 90 days depending on clinical needs and circumstances.
Prenatal care: may be approved for members in second or third trimester and continuing through post‑partum care related to the delivery.

Key Definitions

Continuation of Care — definition

DefinitionContinuation of Care: permitting continuity of care for a new member who is receiving prenatal care or is in active treatment for an acute or chronic condition when their provider has left the Anthem BCBS network

PurposeTo allow approval of visits with an out‑of‑network provider to continue current treatment or prenatal care under specified conditions

ConfidentialityInformation submitted will be kept confidential and used in accordance with applicable privacy laws; may be shared with the member's PCP or specialist to facilitate continuity

Active treatment — definition and examples

DefinitionActive treatment: ongoing treatment (including prenatal care) for an acute or chronic condition where visits may be approved through the current treatment period or up to 90 days

Includes prenatal carePrenatal care in the second or third trimester is considered active treatment and may be approved; continuation may include postpartum care directly related to delivery

ScopeApplies when the member is receiving care from a provider who has left the Anthem Blue Cross and Blue Shield network

OpenPayer

Continuation of Care Form / Continuation of Care for members from non-contracted providers

Continuation / Transitional Care Approval Criteria

Form Identifier and Approval Duration

How to Request Continuation of Care

Key Definitions