Indiana
Provider Communications

July 2020 Anthem Provider News - Indiana

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Title Category

2020 affirmative statement concerning utilization management decisions

Medicare

2020 Special Needs Plans

Medicare

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

Federal Employee Plan (FEP)

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

Administrative

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

Pharmacy

Coding spotlight: Provider’s guide to code social determinants of health

Medicaid

Complex case management program

Medicaid

Important change to prior authorization requests for inpatient hospital admissions*

Administrative

Important information about utilization management

Medicaid

In-Office Assessment Program

Medicare

Medicaid News - July 2020

View these Medicaid articles:
- Modifier use reminders
- MCG care guidelines – 24th edition
- 2020 affirmative statement concerning utilization management decisions
Medicaid

Medical drug benefit clinical criteria updates

Medicare

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
Medicare

Member rights’ and responsibilities statement

Medicaid

New MCG 24th Edition Guidelines

Medical Policy & Clinical Guidelines

Notice of Changes to Prior Authorization Requirements - July 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
Administrative

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

Medicare

Prior authorization requirements for angiographic evaluation of stenotic or thrombosed dialysis circuits

Medicaid

Q-HIP update to Indiana facilities

Administrative

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

Products & Programs

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

Medical Policy & Clinical Guidelines

Updated coverage for HIV PrEP medications

Pharmacy

Welcome to the Custom Learning Center in Availity

Administrative
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