Colorado
Provider Communications

Articles

Title Publication Category Date

Review of professional claims with emergency room level 5 E/M codes - *CORRECTION: For more information, refer to article published May 16, 2019.

May 2019 Anthem Provider Newsletter - Colorado Reimbursement Policies May 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Colorado Medicare Jun 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

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

December 2018 Anthem Provider Newsletter - CO Medical Policy & Clinical Guidelines Dec 1, 2018

Request a Clinical Appeal through new functionality in our Interactive Care Reviewer (ICR) tool on Availity

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

Reminder: Review ICD-10-CM Coding Guidelines (Professional)

February 2019 Anthem Provider Newsletter - CO Reimbursement Policies Feb 1, 2019

REMINDER: New AIM Rehabilitative Program effective April 1, 2019

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

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

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

Reminder: HCPCS code A0998 Ambulance response and treatment with no transport is active and available for use

January 2019 Anthem Provider Newsletter - CO Administrative Jan 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

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

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

Reminder about System Updates

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

Reminder - Anthem follows Original Medicare policies

February 2019 Anthem Provider Newsletter - CO Medicare Feb 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

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

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

Reimbursement Policy Update Modifier 62: Co-Surgeons

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

Reimbursement Policy Update - Claims requiring additional documentation (Facility)

September 2018 Anthem Provider Newsletter - CO Reimbursement Policies Aug 31, 2018

Reimbursement Policies are available online

August 2018 Anthem Provider Newsletter - CO Reimbursement Policies Aug 17, 2018

Reimbursement Policies are available online

September 2018 Anthem Provider Newsletter - CO Reimbursement Policies Aug 31, 2018

Reimbursement Policies are available online

October 2018 Anthem Provider Newsletter - CO Reimbursement Policies Oct 1, 2018

Reimbursement Policies are available online

December 2018 Anthem Provider Newsletter - CO Reimbursement Policies Dec 1, 2018

Reimbursement Policies are available online

January 2019 Anthem Provider Newsletter - CO Reimbursement Policies Jan 1, 2019

Reimbursement Policies are available online

February 2019 Anthem Provider Newsletter - CO Reimbursement Policies Feb 1, 2019

Reimbursement for Convenience Surgical Supply Kits - Professional

December 2018 Anthem Provider Newsletter - CO Reimbursement Policies Dec 1, 2018

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

Readmission (Facility Reimbursement Policy - Update)

October 2018 Anthem Important Updates - CO Administrative Oct 1, 2018

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

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative 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

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

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

Provider Transparency Update

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Provider Transparency Update

March 2019 Anthem Provider Newsletter - CO Products & Programs Mar 1, 2019

Provider Transparency Update

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Provider Transparency Update

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

Provider News site enhancements

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

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

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

Provider and Facility Manual update effective February 1, 2019 - CO

Provider and Facility Manual update effective February 1, 2019 - CO Administrative Dec 28, 2018

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

February 2019 Anthem Provider Newsletter - CO Administrative Feb 1, 2019

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Provider Action Needed: verify your information is correct, and update us with any changes utilizing our online Provider Maintenance Form

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

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

October 2018 Anthem Important Updates - CO Administrative Oct 1, 2018

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

December 2018 Anthem Important Updates - CO Reimbursement Policies Dec 1, 2018

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

February 2019 Anthem Important Updates - CO Reimbursement Policies Feb 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

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

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

Pre-Service/Prior Authorization Clinical Review Update -- September 2019 (MAC)

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

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

Pre-certification/Pre-authorization requirement changes effective January 1, 2020 (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Pre-certification request turnaround times for the Federal Employee Program

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

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

Please evaluate statin use for Medicare Advantage members with diabetes, cardiovascular disease

November 2018 Anthem Provider Newsletter - CO Medicare Nov 1, 2018

Plans offered in 2019

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

Place of Service (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Oct 1, 2019

Pharmacy information available on anthem.com

August 2018 Anthem Provider Newsletter - CO Pharmacy Aug 17, 2018

Pharmacy information available on anthem.com

October 2018 Anthem Provider Newsletter - CO Pharmacy Oct 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - CO Pharmacy Dec 1, 2018

Pharmacy information available on anthem.com

February 2019 Anthem Provider Newsletter - CO Pharmacy Feb 1, 2019

Pharmacy information available on anthem.com

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

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

Pharmacy information available at anthem.com

April 2019 Anthem Provider Newsletter - Colorado Pharmacy Apr 1, 2019

Pharmacy information available at anthem.com

June 2019 Anthem Provider Newsletter - Colorado Pharmacy Jun 1, 2019

Pharmacy information available at anthem.com

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

PCP after-hours access requirements

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Patient360 enhancement for medical providers

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

Partial hospitalization services

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Partial Hospitalization and Intensive Outpatient Program Services (Facility Reimbursement Policy - New)

April 2019 Anthem Important Updates - Colorado Reimbursement Policies Apr 1, 2019

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Provider News and Important Updates - Colorado Medicare Jul 1, 2019

Outpatient Rehabilitation Program transition: new prior authorization requirements

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

Options for helping members avoid ER visits during flu season

November 2018 Anthem Provider Newsletter - CO Products & Programs Nov 1, 2018

Once per Lifetime Procedures – Professional

August 2018 Anthem Provider Newsletter - CO Reimbursement Policies Aug 17, 2018

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

Now Available: Get patient payments faster with Healthcare Bill Payments at anthem.com

September 2018 Anthem Provider Newsletter - CO Administrative Aug 31, 2018

Nonpreferred products and corresponding preferred alternatives

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

Non-participating lab referrals

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Non-participating lab referrals

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

Non-participating lab referrals

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Non-participating lab referrals

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Non-participating lab referrals

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

Non-participating lab referrals

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

New Year Brings New ID Cards - and New ID Numbers - for Many Anthem Members

January 2019 New Year Brings New ID Cards and New ID Numbers for Many Anthem Members - CO Administrative Jan 25, 2019

New specialty Medicare Part B device preferred product program

February 2019 Anthem Provider Newsletter - CO Medicare Feb 1, 2019

New service types added to Availity

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 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

New process to submit claim payment disputes electronically

October 2018 Anthem Provider Newsletter - CO Administrative Oct 1, 2018

New pre-certification requirement for EGD services begins November 1, 2018

August 2018 Anthem Important Updates - CO Administrative Aug 17, 2018

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

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
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