Indiana
Provider Communications

April 2019 Anthem Provider Newsletter - Indiana

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Title Category

Notice of Changes to Prior Authorization Requirements: April 2019

New Prior Authorization Requirements for providers and/or Material Changes to Contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
Administrative

New on Interactive Care Reviewer (ICR): Request Clinical Appeals

Administrative

UM Process Change: Courtesy approval determination notifications

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

Administrative

Why do patients stop taking their prescribed medications and what can you do to help them?

Administrative

Correction: Cervical length measurement by transvaginal ultrasound

Medicaid

Coding Spotlight: Cancer - A provider’s guide to properly code cancers

Medicaid

Access patient-specific drug benefit information through electronic medical records

Medicaid

Practitioners’ rights during credentialing process

Medicaid

Provider surveys

Medicaid

Update: Evaluation and management with Modifier 25

Medicaid

Medical Policy and Clinical Guidelines Updates - April 2019*

Medical Policy & Clinical Guidelines

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Update regarding evaluation and management with modifier 25

Medicare

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

Medicare

Keep up with Medicare news - April 2019

Medicare

Pharmacy information available at anthem.com

Pharmacy

Anthem expands specialty pharmacy prior authorization list*

Pharmacy

New AIM Rehabilitative program effective July 1, 2019

Products & Programs

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

Reimbursement Policies
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