Indiana
Provider Communications

September 2020 Anthem Provider News - Indiana

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Title Category

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program continues

Administrative

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Attention workers’ compensation network providers

Administrative

EDI Gateway migration deadline is September 15, 2020

Administrative

Enhanced medical records submission process to support claims processing

Administrative

Medicaid News - September 2020

View these Medicaid article:
- Medical drug benefit clinical criteria updates
- Submit behavioral health authorizations via our online Interactive Care Reviewer tool
Medicaid

Medical drug benefit clinical criteria updates

Medicare

Medical policies and clinical utilization management guidelines update

Medicaid

Meet your Cancer Care Navigator

Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.
Products & Programs

New provider directory indicators for medication assisted treatment (MAT) providers

Administrative

Notice of Changes to Prior Authorization Requirements - September 2020

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

Patient360 adds care gap alert feedback for medical providers

Administrative

Predictive analytics guide proactive support to patients undergoing chemotherapy resulting in lowered admissions

Products & Programs

Provider demographics update

Medicaid

Providers can now receive and respond to medical record requests for post-pay audit via Change Healthcare’s Assurance Attach Assist Module

Administrative

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

Reimbursement Policies

Reimbursement policy update: Frequency Editing (Professional)*

Reimbursement Policies

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020*

Products & Programs

Specialty pharmacy updates are available - September 2020*

Pharmacy

Update: Notice of changes to the AIM musculoskeletal program

Medicare
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