California
Provider Communications

August 2021 Anthem Blue Cross Provider News - California

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Title Category

Member grievance and appeals attestation requirement

Participating providers are required to acknowledge (annually) that Member Grievance and Appeals forms, a description of grievance procedures, and assistance in filing grievances are readily available at each contracted provider location(s).

Administrative

Telehealth visits can impact after-hospitalization follow-up care for mental illness

Reductions in missed appointments are significant.

Administrative

Clearing up-coding confusion for retinal eye exams (DRE)

New language for two-year compliance (3072F).
Administrative

Register now for our August CME webinars!

Administrative

Schedule appointments online through Availity

Digital Tools

Preventing claims denials: Shingles vaccine

Know best: Shingles vaccinations are a Medicare Part D benefit whether administered in your office or in the pharmacy.

Medicare

Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907

Medicare

Infliximab Step Therapy – effective July 15, 2021

Medicare

Specialty dose rounding program for certain oncology medications

Pharmacy

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

Pharmacy

Anthem Blue Cross to update formulary lists for commercial health plan pharmacy benefit, October 1, 2021

Pharmacy

Immune globulin adjusted body weight dosing program beginning August 1, 2021

Pharmacy

Pharmacy information available on anthem.com/ca

Pharmacy

Reimbursement policy update: Claims requiring additional documentation (facility)

Reimbursement Policies
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