Georgia
Provider Communications

May 2021 Anthem Provider News - Georgia

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Title Category

2021 Affirmative statement regarding utilization management decisions

Administrative

A helpful and complete guide to covered well-child visits

Administrative

Anthem clinical criteria updates for specialty pharmacy are available

Pharmacy

Anthem’s Digital Provider Enrollment application now available for providers who do not use CAQH

Administrative

Anthem’s new strategic provider system launched in April

Administrative

Clinical guideline update

Medical Policy & Clinical Guidelines

Digital online scheduling feature now available in the Availity portal

Administrative

Fewer repeat visits to the emergency room with follow-up care

Behavioral Health

Georgia Anthem preapproval list change notification 5/1/2021

Material adverse change (MAC)
Policy Updates

Keep up with Medicare news

Medicare Advantage
Medicare

Maximizing efficient, high quality COVID-19 screenings

Medicare Advantage
Medicare

May is national high blood pressure education month

A WISEWOMANTM knows that improving blood pressure is good for the heart
Administrative

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

Products & Programs

New Regional Vice President for Georgia Networks

Administrative

Provider bulletins for medical and itemized bill attachments

Electronic solutions @ your fingertips
Administrative

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

Administrative

Reimbursement policy reminder: readmission (facility)

Reimbursement Policies

Reimbursement policy update: frequency editing (professional)

Reimbursement Policies

Reimbursement policy update: claims requiring additional documentation (facility)

Material adverse change (MAC)
Reimbursement Policies

Resources to support diverse patients and communities

Administrative

Send larger digital attachments through Availity

File size has been expanded to 100 megabytes
Administrative

Update to AIM Specialty Health Oncologic Imaging clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Updated AIM Rehabilitative program effective August 1, 2021: initial evaluations and site of service reviews

Material adverse change (MAC)
Products & Programs

Updated provider manual posted to anthem.com

Administrative

Updates for specialty pharmacy are available (May 2021)

Material adverse change (MAC)
Pharmacy
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