Colorado
Provider Communications

Articles

Title Publication Category Date

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, 2020

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

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

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

Working with Anthem Webinars -- February 2020 schedule: Anthem.com Overview (legacy pages retiring March 31, 2020)

February Working with Anthem webinar: Anthem.com Overview (legacy pages retiring March 31, 2020) - Colorado Administrative Feb 10, 2020

Shine Light on Depression school-based suicide prevention initiative

February 2020 Anthem Provider News and Important Updates -- Colorado Behavioral Health Feb 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Feb 1, 2020

Working with Anthem Webinars -- February 2020 schedule: Anthem.com Overview (legacy pages retiring March 31, 2020)

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

UPDATE: New AIM Rehabilitative Program effective April 1, 2020

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

Anthem SOAP Notes/Health Assessments for 2019 calendar year are due February 15, 2020

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

Pre-Service/Prior Authorization Clinical Review Update -- February 2020 (MAC)

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

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program: Joint Surgery and Spine Surgery (MAC)

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

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

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

Medical Policy and Clinical UM Guidelines notification letter (MAC)

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

Clinical Laboratory Improvement Amendments (CLIA) claim requirements effective May 1, 2020 (MAC)

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

Reimbursement Policy Update Modifier 62: Co-Surgeons

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

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

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

Keep up with Medicare news

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

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

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

New Musculoskeletal and Pain Management Solution Effective for Select National ASO Accounts January 1, 2020

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

Upcoming retirement planned for legacy Medical Attachment submission tool

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

Let us help you accomplish your 2020 “To Do” list early – EDI Migration

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

New Year brings new ID cards for many Anthem members

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

Drug fee schedule update

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

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

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

Help protect your patients by providing medical ID protection -- best practices

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

Medical drug benefit Clinical Criteria updates – October 2019

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

Medical drug benefit Clinical Criteria updates – November 2019

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

New Pathway PPO network to support new product offerings available January 1, 2020

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

Working with Anthem Webinars -- January 2020 schedule: Pathway PPO Overview

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

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

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

Dispatch Health: An extension of your team - Innovative On-demand Healthcare at Home

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

Outpatient facility edit implementation effective April 26, 2020 (MAC)

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

2020 FEP® Benefit information available online

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

Introducing two new Medicare Advantage special needs plans for 2020

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

Postponed -- Review of professional claims with emergency room level 5 E/M codes

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

Keep up with Medicare news

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

Coding Tip for Psychological and Neuropsychological Testing

December 2019 Anthem Provider News and Important Updates - Colorado Behavioral Health Dec 1, 2019

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Case Management Program

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Coordination of Care

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Retrieve your Anthem Patient’s HEDIS® care gaps through Patient360 located on the Availity Portal

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

System updates for 2020 (Professional)

December 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Dec 1, 2019

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News and Important Updates - Colorado Medicare Dec 1, 2019

Pharmacy information available on anthem.com

December 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Dec 1, 2019

Working with Anthem Webinars -- January 2019 schedule: Pathway PPO Overview

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Non-participating lab referrals

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Important Information about Utilization Management

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Members’ Rights and Responsibilities

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Medical Policy and Clinical UM Guidelines notification (MAC)

Material Adverse Change (MAC)
December 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Dec 1, 2019

New Reimbursement Policies (Professional): Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers

December 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Dec 1, 2019

Coordination of Benefits for an FEP® member

December 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Dec 1, 2019

Keep up with Medicare news

December 2019 Anthem Provider News and Important Updates - Colorado Medicare Dec 1, 2019

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

November 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Nov 1, 2019

Anthem appropriate coding helps provide a comprehensive picture of patients’ health

November 2019 Anthem Provider News and Important Updates - Colorado Administrative Nov 1, 2019

Additional improvements coming to anthem.com regarding Medical Policies and Clinical Guidelines

November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

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

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Prior authorization requirements changes effective November 1, 2019

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019
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