Indiana
Provider Communications

August 2021 Anthem Provider News - Indiana

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Title Category

Reimbursement policy update: Virtual Visits (Professional and Facility)*

*Change to Prior Authorization Requirements
Reimbursement Policies

Reimbursement policy update: Claims requiring additional documentation (Facility)*

*Change to Prior Authorization Requirements
Reimbursement Policies

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

*Change to Prior Authorization Requirements
Reimbursement Policies

Some requests to AIM may require documentation to support prior authorization

Products & Programs

Anthem to update formulary lists for commercial health plan pharmacy benefit effective October 1, 2021*

*Change to Prior Authorization Requirements
Pharmacy

Updates for specialty pharmacy are available - August 2021*

*Change to Prior Authorization Requirements
Pharmacy

Specialty dose rounding program for certain oncology medications

Pharmacy

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

Pharmacy

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

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Medicare News - August 2021

View these Medicare articles:
- Infliximab Step Therapy - Effective 7/15/2021
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907
- MCG care guidelines 25th edition
Medicare

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

Medicare

Preventing claims denials: Shingles vaccine

Medicare

Update: AIM Musculoskeletal Program effective November 1, 2021 - Site of care reviews*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Transition to AIM Specialty Health imaging of the heart clinical appropriateness guideline for computed tomography to detect coronary artery calcification

Medical Policy & Clinical Guidelines

Medicaid News - August 2021

View these Medicaid articles:
- MCG care guidelines 25th edition
- Clinical Criteria Updates Notification May-September 2020
Medicaid

Let’s vaccinate

Medicaid

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

Medicaid

What Matters Most: Improving the Patient Experience

Medicaid

Resources to support your diverse patient panel

Medicaid

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

*Change to Prior Authorization Requirements
Federal Employee Plan (FEP)

New! Schedule appointments online through Availity

Digital Tools

Register now for our August CME webinars

Administrative

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

Administrative

Clearing up coding confusion for retinal eye exams (DRE)

Administrative
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