Colorado
Provider Communications

Articles

Title Publication Category Date

Updated Coverage for HIV PrEP medications

July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

Drug fee schedule update

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Federal Employee Plan (FEP) Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Medical drug benefit Clinical Criteria updates

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jul 1, 2020

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

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Updated Prefix Reference List -- Colorado

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

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

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Keep up with Medicare news

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Webinar recording now available for network providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond.

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Colorado Behavioral Health Jun 25, 2020

Information from Anthem for Care Providers about COVID-19 (Updated June 9, 2020)

We recently updated FAQs to reflect the extension of coverage for telehealth and telephonic care.
COVID-19 Information - Colorado Administrative Jun 9, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated June 9, 2020)

We are extending coverage for telehealth and telephone-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Colorado Administrative Jun 9, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated June 3, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Colorado Administrative Jun 3, 2020

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.
June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Anthem enhances process for submitting Behavioral Health Authorizations

June 2020 Anthem Provider News and Important Updates -- Colorado Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News and Important Updates -- Colorado Behavioral Health Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Keep up with Medicare news

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jun 1, 2020

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

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jun 1, 2020

Pharmacy information available on anthem.com

June 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Updated Escalation Contact List -- Colorado

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

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

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jun 1, 2020

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

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Colorado Administrative May 29, 2020

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

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Colorado Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Colorado Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Reminder about System Updates

May 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

Keep up with Medicare news

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

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

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy May 1, 2020

COVID-19 information repository for Anthem care Providers

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

CU Health Plan and UCHealth changes effective July 1, 2020

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Working with Anthem Webinars -- May 2020 schedule: CU Health Plan and UCHealth changes effective July 1, 2020

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Updated Escalation Contact List -- Colorado

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Non-participating lab referrals

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Sleep Disorder Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- MSK Interventional Pain Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

Claims requiring additional documentation (Facility Reimbursement Policy -- Update for Outpatient) (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies May 1, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Colorado Administrative Apr 10, 2020

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

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Apr 1, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Apr 1, 2020

Anthem to delay most April 1, 2020 formulary list updates for commercial health plan pharmacy benefit

April 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Apr 1, 2020

Information from Anthem for Care Providers about COVID-19

Bookmark Provider News Home for the latest information for Care Providers about COVID-19.
April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Working with Anthem Webinars -- April 2020 schedule: New Provider Enrollment Application

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

REMINDER: New AIM Rehabilitative Program effective April 1, 2019

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Important clarification about HMO/Point of Service (POS) health plan information for CHEIBA members

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Updated Networks at a Glance and Networks Overview documents -- Colorado

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Drug fee schedule update

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Provider Transparency Update

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

Anthem continues focus on updates to our public provider website

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition (MAC)

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical record request requirements

April 2020 Anthem Provider News and Important Updates -- Colorado Federal Employee Plan (FEP) Apr 1, 2020

COVID-19 Virus Talking Points - Medicare

April 2020 Anthem Provider News and Important Updates -- Colorado Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for November 2019

April 2020 Anthem Provider News and Important Updates -- Colorado Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for December 2019

April 2020 Anthem Provider News and Important Updates -- Colorado Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News and Important Updates -- Colorado Medicare Apr 1, 2020

Keep up with Medicare news

April 2020 Anthem Provider News and Important Updates -- Colorado Medicare Apr 1, 2020

Updated COVID-19 Medicare Information

For the latest COVID-19 Medicare information, please check Medicare Advantage Provider News Archives.
COVID-19 Information - Colorado Medicare Mar 25, 2020

Anthem acquires Beacon Health Options

April 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 2, 2020

Commercial Risk Adjustment (CRA) Program Update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Modifier use reminders

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Important coding reminder for Walk-In Retail Health Clinics

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Patient360 enhancement for medical providers

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG -- W0163 Pelvic Organ Prolapse Repair

March 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements

March 2020 Anthem Provider News and Important Updates -- Colorado Medicare Mar 1, 2020

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

March 2020 Anthem Provider News and Important Updates -- Colorado Medicare Mar 1, 2020

Nonpreferred products and corresponding preferred alternatives

March 2020 Anthem Provider News and Important Updates -- Colorado Medicare Mar 1, 2020

Keep up with Medicare news

March 2020 Anthem Provider News and Important Updates -- Colorado Medicare Mar 1, 2020

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020 (MAC)

Material Adverse Change (MAC)
March 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Mar 1, 2020

Pharmacy information available on anthem.com

March 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Mar 1, 2020

Working with Anthem Webinars -- March 2020 schedule: Availity tools and functionality overview

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Provider News site enhancements

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Updated Escalation Contact List -- Colorado

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Updated Prefix Reference List -- Colorado

March 2020 Anthem Provider News and Important Updates -- Colorado Administrative Mar 1, 2020

Clinical guideline update effective June 1, 2020 -- CG-SURG-92 / Paraesophageal Hernia Repair (MAC)

Material Adverse Change (MAC)
March 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Mar 1, 2020
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