Georgia
Provider Communications

August 2021 Anthem Provider News - Georgia

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Title Category

Anthem clinical criteria updates for specialty pharmacy are available

Pharmacy

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

August 2021 updates for specialty pharmacy are available

Material adverse change (MAC): prior authorization updates
Pharmacy

Change in email submission of service requests for Federal Employee Program® members

Material adverse change (MAC)
Federal Employee Plan (FEP)

Clearing up coding confusion for retinal eye exams (DRE)

3072F: new language about two-year compliance.
Administrative

Digital scheduling feature in the Availity portal: the Appointment Scheduler application

Digital Tools

Immune globulin adjusted body weight dosing program beginning August 1, 2021

Pharmacy

Keep up with Medicare news

Medicare Advantage
Medicare

New clinical guideline: Home Parenteral Nutrition, effective November 1, 2021

Material adverse change (MAC)
Medical Policy & Clinical Guidelines

Pharmacy information available on anthem.com

Pharmacy

Preventing claims denials: shingles vaccine

Medicare Advantage
Medicare

Register now for our August CME webinars!

Administrative

Reimbursement policy update: Virtual Visits (professional and facility)

Material adverse change (MAC)
Reimbursement Policies

Reimbursement policy update: claims requiring additional documentation (facility)

Reimbursement Policies

Reimbursement policy update: Distinct Procedural Service, modifiers 59 and XE, XP, XS, & XU

Material adverse change (MAC)
Reimbursement Policies

Some physician requests to AIM may require the submission of documentation to support attestations for prior authorization

Administrative

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

Pharmacy

Specialty dose rounding program for certain oncology medications

Pharmacy

Telehealth visits can impact after hospitalization follow-up care for mental illness

Administrative

Transition to AIM Specialty Health Imaging of the heart clinical appropriateness guideline for Computed Tomography to Detect Coronary Artery Calcification

Medical Policy & Clinical Guidelines

Updated AIM musculoskeletal program effective November 1, 2021: site of care reviews

Material adverse change (MAC)
Products & Programs
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