California
Provider Communications

Articles Category: State & Federal / Medi-Cal Managed Care

Title Publication Category Date

Antibiotic dispensing guidelines

March 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Mar 1, 2020

Coding spotlight: HIV and AIDS

March 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Mar 1, 2020

Reimbursement new policy: Update drug screen testing

November 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2019

Reminder: Mid-level practitioners are required to file using their NPI

March 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Mar 1, 2020

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2019

Bright Heart Health medication-assisted treatment program

March 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Mar 1, 2020

Restoration of optional benefits

March 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Mar 1, 2020

COVID-19 Virus Talking Points

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Coding tip for psychological and neuropsychological testing

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Medical drug benefit Clinical Criteria updates for November 2019

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Botox® update for Anthem Blue Cross members

January 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jan 1, 2022

Medical drug benefit Clinical Criteria updates for December 2019

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

2021 CAHPS Survey results

January 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jan 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jan 1, 2022

Disease Management can help you care for patients with chronic health care needs

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Keep up with Medi-Cal news – January 2022

January 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jan 1, 2022

Multiple and bilateral surgery, professional and facility reimbursement policy update

Policy 06-010, effective 05/01/20, revised 03/01/20

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

HEDIS 2022: Summary of changes from NCQA

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

Use of imaging studies for Low back Pain (LBP)

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Chlamydia screening

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

New specialty pharmacy medical injectable step therapy requirements

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Using SBIRT to address opioid and substance use disorders

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

New specialty pharmacy medical step therapy requirements

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Updated quality performance requirements

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

Access to care standards

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

The cost of alcohol use disorder

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

Clinical criteria updates

May 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care May 1, 2019

Prior authorization requirements: new 2020 codes for coverage and precertification

April 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Apr 1, 2020

Prior authorization requirement changes updated effective date November 1, 2022

August 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Aug 1, 2022

Electronic claim payment reconsideration

May 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care May 1, 2019

Latest updates to Electronic Data Interchange Gateway migration

May 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care May 1, 2019

Reimbursement Policy update – effective May 1, 2021

Preadmission Services for Inpatient Stays

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

CAHPS® survey

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

HEDIS Measurement year 2020: Medi-Cal summary of changes from NCQA

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Update to Clinical Practice Guidelines and Preventive Health Care Guidelines

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Updated quality performance requirements

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Prior authorization requirements for 55899

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Radiotherapies and radioimmunotherapies will require prior authorization

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Medical drug benefit Clinical Criteria updates

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards

New additional benefit detail.

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

What matters most online training course: Improving patient experience

September 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Sep 1, 2020

New specialty pharmacy medical step therapy requirements

February 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Feb 1, 2021

Medical drug benefit Clinical Criteria updates

September 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Sep 1, 2020

Medical policies and clinical utilization management guidelines update

September 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Sep 1, 2020

Prior authorization requirements for E0482

October 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2020

Coding spotlight: Providers guide to coding for behavioral health disorders

October 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2020

New reimbursement policy – Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem Blue Cross results in improved care management for patients

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Prior authorization requirements for Cabazitaxel (Jevtana

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Coding spotlight: Mental disorders in childhood

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Prior authorization requirement for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

What matters most: Improving the patient experience

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Anthem Blue Cross adopts 22nd edition of the MCG care guidelines

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Resources to support your diverse patient panel

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Regulatory updates

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Infusion step therapy retraction notice

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Important information about utilization management

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Specialty pharmacy prior authorization retraction notice

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Member rights and responsibilities statement

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

February 2021 medical policies and utilization management guidelines update

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Coding spotlight: Obesity

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Prior authorization requirement changes effective September 1, 2021 – UM AROW 1327

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Electronic data interchange migration to Availity

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Certain specialty medication precertification requests may require additional documentation

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Reimbursement policy update; Medical recalls, policy 06-111 – effective November 1, 2018

August 2018 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Aug 16, 2018

Let’s vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies
July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Prior authorization requirement changes effective October 1, 2021 – UM AROW 1837

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

March 2021 medical drug benefit clinical criteria updates

July 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Jul 1, 2021

Discharges against medical advice

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

Coding spotlight: Diabetes

February 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Feb 1, 2019

Claims editing update for ICD-10-CM Excludes 1 notes

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

New specialty pharmacy medical step therapy requirements

February 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Feb 1, 2019

Clinical criteria updates

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

Expedited grievances

May 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care May 1, 2022

Unspecified diagnosis reminder

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care May 1, 2022

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

February 2019 Anthem Blue Cross Provider Newsletter - California Medi-Cal Managed Care Feb 1, 2019

Pharmacy services to be fee-for-service benefit

November 2021 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2021

Keep up with Medi-Cal news – May 2022

May 2022 Anthem Blue Cross Provider News - California Medi-Cal Managed Care May 1, 2022

June 2019 medical policies and clinical utilization management guidelines update

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

New clinical guideline: pneumatic compression devices, effective December 1, 2019

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

Help prevent pre-eclampsia with prenatal aspirin

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

Reimbursement policy update: Early and periodic screening, diagnostic and treatment (EPSDT)

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

Provider Chat – a fast, easy way to get your questions answered

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

Regulatory updates

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

New specialty pharmacy medical step therapy requirements

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

Pharmacy benefit manager change to IngenioRx

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

Reimbursement Policy update: Nurse practitioner and physician assistant services, professional

Policy 20-002, effective 04/24/20

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

March 2019 Medical policies and clinical utilization management guidelines update

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

Coding spotlight: Tips and best practices for compliance

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

Coming soon: electronic attachments

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

Medical drug benefit Clinical Criteria updates

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

Prior authorization requirements for Global March MPTAC CCRT configuration

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

New specialty pharmacy medical step therapy requirements

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020

MCG Care guidelines update and customizations

October 2019 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Oct 1, 2019

November 26 is National Family Health History Day

November 2020 Anthem Blue Cross Provider News - California Medi-Cal Managed Care Nov 1, 2020
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