California
Provider Communications

August 2021 Anthem Blue Cross Provider News - California

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Title Category

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

Pharmacy

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

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

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

Pharmacy

Infliximab Step Therapy – effective July 15, 2021

Medicare

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

Pharmacy information available on anthem.com/ca

Pharmacy

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

Register now for our August CME webinars!

Administrative

Reimbursement policy update: Claims requiring additional documentation (facility)

Reimbursement Policies

Schedule appointments online through Availity

Digital Tools

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

Pharmacy

Specialty dose rounding program for certain oncology medications

Pharmacy

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

Reductions in missed appointments are significant.

Administrative
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