Colorado
Provider Communications

Articles

Title Publication Category Date

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

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

AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Oncology (MAC)

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

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

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

Clinical practice and preventive health guidelines available on anthem.com

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

Expenses Included in Facility Services (Professional Reimbursement Policy) -- New (MAC)

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

Bundled Services and Supplies (Professional Reimbursement Policy) -- Update

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

Digital transactions cut administrative tasks in half

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

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

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

2021 Medicare Advantage individual benefits and formularies

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

Medical Policies and Clinical Utilization Management Guidelines update

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

Keep up with Medicare news

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

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

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

IngenioRx Introduces New Pharmacy Network in 2021

November 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Nov 1, 2020

US Antibiotic Awareness Week

November 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Nov 1, 2020

Working with Anthem Webinars -- November 2020 schedule: Blue High Performance Network (HPN)

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

Availity Attachment Tools for Anthem and Affiliate Payers -- Live Webinars

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

Get the full picture of your patient’s health through their smartphone

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

Digital transactions cut administrative tasks in half

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

Non-participating lab referrals

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

Clinical Laboratory Improvement Amendments (CLIA) Number -- Additional Information

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

Medical Policy and Clinical UM Guidelines notification letter (MAC)

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

REMINDER: Post-service reviews using AIM

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

Documentation Standards for Episodes of Care (Professional Reimbursement Policy) -- New (MAC)

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

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)

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

Bundled Services and Supplies (Professional Reimbursement Policy) – Update (MAC)

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

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

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

Preferred continuous glucose monitors

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

Provider Chat -- A fast, easy way to get your questions answered

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

Medical drug benefit Clinical Criteria updates -- June 2020

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

FDA approvals and expedited pathways used -- new molecular entities

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

Keep up with Medicare news

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

Register today for a Racial Trauma Forum hosted by Anthem and Motivo on October 28, 2020

Racial Trauma Forum Invitation - Colorado Behavioral Health Oct 14, 2020

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

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

Updated Coverage for Breast Cancer prevention medications

October 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Oct 1, 2020

FDA approvals and expedited pathways used -- New Molecular Entities (NMEs)

October 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Oct 1, 2020

Pharmacy information available on anthem.com

October 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Oct 1, 2020

Anthem updates formulary lists for commercial health plan pharmacy benefit

October 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Oct 1, 2020

Network Relations Team Updates -- Colorado

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

New Pathway Essentials network in Colorado to support new product offerings available in January 1, 2021

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

Working with Anthem Webinars -- October 2020 schedule: Pathway Essentials

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

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

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

New Medical Claim Attachment Webinars: Register Today

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

What Matters Most: Improving the Patient Experience

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

Electronic member ID cards available on the Availity Portal

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

Drug fee schedule update

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

Commercial Risk Adjustment (CRA) Reporting Update: New guidance on telephone-only service CPT codes

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

National Accounts 2021 Pre-certification list

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

REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020

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

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines delayed

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

Laboratory and Venipuncture Services (Professional Reimbursement Policy) -- Update (MAC)

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

Reimbursement policy update -- Claims Requiring Additional Documentation policy (Facility)

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

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List (MAC)

Material Adverse Change (MAC)
October 2020 Anthem Provider News and Important Updates -- Colorado Federal Employee Plan (FEP) Oct 1, 2020

Medical drug benefit Clinical Criteria updates (June 2020)

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

Patient360 enhancement for medical providers

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

Provider transparency update

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

Prior authorization requirements for the below codes

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

Update: Notice of changes to the AIM musculoskeletal program

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

Social determinants of health support expanding with GroundGame Health

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

Keep up with Medicare news

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

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

September 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Sep 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

September 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Sep 1, 2020

Anthem Chat: A fast, easy way to have your questions answered

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

EDI Gateway Migration Deadline is September 15, 2020

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

Enhanced Medical Records Submission Process to Support Claims Processing

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

Patient360 Adds Care Gap Alert Feedback for Medical Providers

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

Receive and respond to medical record requests for postpay audit via Change Healthcare’s Attach Assist functionality

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

Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program Continues

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

Medical drug benefit Clinical Criteria updates (May 2020)

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

Site of Care* medical necessity reviews expand to numerous surgical procedures begin December 1, 2020 (MAC)

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

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

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

Working with Anthem Webinars -- September 2020 schedule: Provider Claim Questions/Issue Resolution Process Flow

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

New provider directory indicators for medication assisted treatment (MAT) providers

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

National Account members living in Colorado utilizing the Pathway network

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

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)

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

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

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

Keep up with Medicare news

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

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

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

Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Working with Anthem Webinars -- August 2020 schedule: Quick Tips for adding, changing, terming a provider using the Provider Maintenance Form

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

Quick Tips: adding, changing, terming a provider using the Provider Maintenance Form

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

Change Notification to Provider and Facility Manual effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Expansion of AIM Musculoskeletal Program Effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Commercial Risk Adjustment (CRA): Appropriate coding helps provide a comprehensive picture of patients’ health

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

Non-participating lab referrals

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

Resources to support diverse patients and communities

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

Migrate Your EDI Transactions to Availity Today

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

Anthem Electronic Attachments -- X12 275 5010

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

Prior Authorization/Referral Request and Inpatient Admission/Discharge Notification transactions coming soon

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

Clinical Laboratory Improvement Amendments (CLIA) ID number required for electronic claims submissions

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

Updated Escalation Contact List -- Colorado

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

Medical Policy and Clinical UM Guidelines notification letter (MAC)

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

Medical Record Standards

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

Reimbursement policy update -- Claims Requiring Additional Documentation (Facility)

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

Medical drug benefit Clinical Criteria updates

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

2020 Medicare risk adjustment provider trainings

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

New MCG Care Guidelines 24th edition

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

AIM Musculoskeletal program expansion

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

Keep up with Medicare news

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