California
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

Anthem Blue Cross (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Blue Cross Provider News - California Medicare Jun 1, 2020

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Blue Cross Provider News - California Medicare Jun 1, 2021

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Blue Cross Provider News - California Medicare Jun 1, 2020

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness

May 2021 Anthem Blue Cross Provider News - California Medicare May 1, 2021

Reminders for Medicare Advantage group retiree PPO plans and national access plus FAQ

June 2021 Anthem Blue Cross Provider News - California Medicare Jun 1, 2021

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Blue Cross Provider News - California Medicare Jun 1, 2020

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Blue Cross Provider News - California Medicare May 1, 2021

Benefits update for Special Supplemental Benefits for the chronically ill

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

Modifier use reminders

June 2020 Anthem Blue Cross Provider News - California Medicare Jun 1, 2020

Helping our members

May 2021 Anthem Blue Cross Provider News - California Medicare May 1, 2021

Prior authorization requirements for CardioMEMs

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

Rehabilitative services prior authorization review update

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

California’s Valued Trust offers a Medicare Advantage option

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

CMS reminder: expedited/urgent requests

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

Personal Home Helper benefit

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

Bill Medicare Part D for shingles or tetanus vaccination claims

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

Nonpreferred products and corresponding preferred alternatives

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

New MA Opioid Treatment Program benefit

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

2019 Enhanced Personal Health Care program releases myFHR

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

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

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

Medical Policies and Clinical Utilization Management Guidelines update

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement (APM ID 0037943)

March 2020 Anthem Blue Cross Provider News - California Medicare Mar 1, 2020

Prior authorization requirements: new 2020 codes for coverage and precertification

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

New reimbursement policy: Update drug screen testing

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Blue Cross Provider News - California Medicare Nov 1, 2019

Medical drug benefit Clinical Criteria updates for November 2019

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for December 2019

April 2020 Anthem Blue Cross Provider News - California Medicare Apr 1, 2020

Fall prevention tips

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Medical records request for risk adjustment

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Medicare Advantage reimbursement policy provider bulletin

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Important update on Botox® for Medicare members of Anthem Blue Cross

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

Partial hospitalization services

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Los Angeles City Employees’ Retirement System adds the medical and prescription drug plan

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

New incentive program reimbursement for select CPT Category II codes

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Northern California Cement Masons, California moves to Medicare Advantage plan

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

Prior authorization requirements for DME repair and portable oxygen concentrator

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Professional claims – billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

Update: Evaluation and management with Modifier 25

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

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

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

Keep up with Medicare news

May 2019 Anthem Blue Cross Provider Newsletter - California Medicare May 1, 2019

Keep up with Medicare news – January 2022

January 2022 Anthem Blue Cross Provider News - California Medicare Jan 1, 2022

Preventing claims denials: Shingles vaccine

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

August 2021 Anthem Blue Cross Provider News - California Medicare Aug 1, 2021

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

August 2021 Anthem Blue Cross Provider News - California Medicare Aug 1, 2021

Infliximab Step Therapy – effective July 15, 2021

August 2021 Anthem Blue Cross Provider News - California Medicare Aug 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing Providers Nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 2021

PN for UM AROW Item 1330

February 2021 Anthem Blue Cross Provider News - California Medicare Feb 1, 2021

IBEW Local 234, CA moves to Medicare Advantage plan under Anthem Blue Cross

February 2021 Anthem Blue Cross Provider News - California Medicare Feb 1, 2021

Medical drug benefit Clinical Criteria updates

September 2020 Anthem Blue Cross Provider News - California Medicare Sep 1, 2020

Medical drug benefit Clinical Criteria updates

February 2021 Anthem Blue Cross Provider News - California Medicare Feb 1, 2021

Prior authorization requirements for the below codes

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Evaluation and management services correct coding

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Medical drug benefit Clinical Criteria updates

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

In-office assessment program

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

May 2020 medical policies and clinical utilization management guidelines update

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Coming soon, electronic attachments

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Prior authorization requirements for the below codes

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Prior authorization requirements for Global March MPTAC CCRT configuration

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Update: Notice of changes to the AIM musculoskeletal program

October 2020 Anthem Blue Cross Provider News - California Medicare Oct 1, 2020

Aspire Telehealth Palliative Care program

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Clinical laboratory improvement amendments for Anthem Blue Cross

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Los Angeles Unified School District (LAUSD) Offers Medicare Advantage Option

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

Reminder: Anthem follows original Medicare policies

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

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

July 2021 Anthem Blue Cross Provider News - California Medicare Jul 1, 2021

MA members receive incentives for completing screenings

August 2018 Anthem Blue Cross Provider Newsletter - California Medicare Aug 16, 2018

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

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 Medicare Jul 1, 2021

DME providers and physicians: important wheelchair prior authorization information

August 2018 Anthem Blue Cross Provider Newsletter - California Medicare Aug 16, 2018

New specialty Medicare Part B device preferred product program

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428

July 2021 Anthem Blue Cross Provider News - California Medicare Jul 1, 2021

Submit PA medication requests electronically; new phone number for MA prescription PAs

August 2018 Anthem Blue Cross Provider Newsletter - California Medicare Aug 16, 2018

Keep up with Medicare news

February 2019 Anthem Blue Cross Provider Newsletter - California Medicare Feb 1, 2019

March 2021 Medical drug benefit clinical criteria updates

July 2021 Anthem Blue Cross Provider News - California Medicare Jul 1, 2021

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

August 2018 Anthem Blue Cross Provider Newsletter - California Medicare Aug 16, 2018

March 2019 medical policies and clinical utilization management guidelines update

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

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 Medicare Jul 1, 2021

Keep up with Medicare news

August 2018 Anthem Blue Cross Provider Newsletter - California Medicare Aug 16, 2018

June 2019 medical policies and clinical utilization management guidelines update

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Lowering health risks with no-cost statins

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Blue Cross Provider News - California Medicare May 1, 2022

Medical drug clinical criteria updates

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

New Strategic Provider System implementation May 2022

May 2022 Anthem Blue Cross Provider News - California Medicare May 1, 2022

Assisting your patients in managing the Donut Hole

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

HEDIS 2022: Summary of changes from NCQA

May 2022 Anthem Blue Cross Provider News - California Medicare May 1, 2022

Prior authorization requirements for continuous positive airway pressure supplies

October 2019 Anthem Blue Cross Provider News - California Medicare Oct 1, 2019

New specialty pharmacy medical step therapy requirements

May 2022 Anthem Blue Cross Provider News - California Medicare May 1, 2022

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

Anthem transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

Please evaluate statin use for MA members with diabetes, cardiovascular disease

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

Medicare pharmacy and prescriber home starts January 2019

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

CalPERS Medicare Advantage plan members to receive new ID cards

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

New Medicare Advantage provider service phone number beginning January 1, 2019

December 2018 Anthem Blue Cross Provider Newsletter - California Medicare Dec 1, 2018

Keep up with Medicare news

October 2018 Anthem Blue Cross Provider Newsletter - California Medicare Oct 1, 2018

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

April 2019 Anthem Blue Cross Provider Newsletter - California Medicare Apr 1, 2019

Prior authorization requirements for the below codes

November 2020 Anthem Blue Cross Provider News - California Medicare Nov 1, 2020
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