Indiana
Provider Communications

August 2020 Anthem Provider News - Indiana

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Title Category

2020 Medicare risk adjustment provider trainings

Medicare

Anthem electronic attachments - X12 275 5010

Administrative

Anthem prior authorization updates for specialty pharmacy are available - August 2020*

Pharmacy

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

Coding spotlight: Provider guide to coding for cardiovascular conditions

Medicaid

Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

Administrative

Electronic claims submission - Clinical Laboratory Improvement Amendments (CLIA)

Administrative

Evaluation and management services correct coding (Professional)

Administrative

Expansion of AIM Musculoskeletal Program effective November 1, 2020*

Medical Policy & Clinical Guidelines

Follow-up after hospitalization for mental illness

Medicaid

Medicaid News - August 2020

View these Medicaid articles:
- Separately reimbursable DME when implanted in an outpatient setting – billing reminder
- Mid-level behavioral health and substance use providers may not bill evaluation and management services codes
Medicaid

Medical drug benefit clinical criteria updates

Medicare

Medical drug benefit clinical criteria updates

Medicaid

Medical policy and clinical guideline updates - August 2020*

Medical Policy & Clinical Guidelines

Medical record standards

Administrative

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
Medicare

Migrate your EDI transactions to Availity today

Administrative

Notice of changes to prior authorization requirements - August 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
- Anthem prior authorization updates for specialty pharmacy are available-August 2020*
- Medical Policy and Clinical Guideline Updates-August 2020*
- Expansion of AIM Musculoskeletal Program effective November 1, 2020*
- Reimbursement Policy Update: Claims requiring additional documentation (Facility)*
Administrative

Pharmacy information available on anthem.com

Pharmacy

Provider contract and fee schedule notifications coming soon

Administrative

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

Reimbursement Policies

Resources to support diverse patients and communities

Administrative

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

Pharmacy
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