Colorado
Provider Communications

July 2020 Anthem Provider News and Important Updates -- Colorado

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Title Category

2020 Special Needs Plans

Medicare

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

Federal Employee Plan (FEP)

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
Pharmacy

Commercial Risk Adjustment (CRA) 2020 Program Year Progression: What’s in it for you and your patients?

Administrative

Drug fee schedule update

Administrative

Keep up with Medicare news

Medicare

Medical drug benefit Clinical Criteria updates

Medicare

New MCG 24th Edition Guidelines

Medical Policy & Clinical Guidelines

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

Medicare

Provider claim questions/issue resolution process flow for Colorado -- Commercial members

Administrative

Provider claim questions/issue resolution process flow for Colorado -- Medicare members

Medicare

UPDATE: New Go Live Date for Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures

Products & Programs

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Updated Coverage for HIV PrEP medications

Pharmacy

Updated Prefix Reference List -- Colorado

Administrative

Welcome to the Custom Learning Center in Availity

Administrative

Working with Anthem Webinars -- July 2020 schedule: Anthem Networks Overview

Administrative
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