Colorado
Provider Communications

June 2020 Anthem Provider News and Important Updates -- Colorado

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Title Category

2020 Medicare risk adjustment provider trainings

Medicare

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
Administrative

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

Medicare

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

Administrative

Anthem enhances process for submitting Behavioral Health Authorizations

Behavioral Health

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Administrative

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

Material Adverse Change (MAC)
Pharmacy

Availity Portal Notification Center

Administrative

Diabetes HbA1c < 8 HEDIS guidance

Medicare

Keep up with Medicare news

Medicare

Modifier use reminders

Medicare

Nurse Practitioner and Physician Assistant Service (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Pharmacy information available on anthem.com

Pharmacy

Quality Corner: Follow-Up after Hospitalization for Mental Illness

Behavioral Health

Quality Corner: CPT® Category II codes – Collaborating for enhanced patient care

Administrative

Reminder: CU Health Plan and UCHealth changes effective July 1, 2020

Administrative

Transition to AIM Clinical Appropriateness Guidelines -- Rehabilitative Services (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

Products & Programs

Updated Escalation Contact List -- Colorado

Administrative

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medicare

Working with Anthem Webinars -- June 2020 schedule: Anthem onboarding for physical health and behavioral health providers

Administrative
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