Maine
Provider Communications

April 2021 Anthem Maine Provider News

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Title Category

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

Administrative

Chat directly with a prior authorization specialist

Administrative

Clinical criteria updates for specialty pharmacy

Pharmacy

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

Pharmacy

CPT code E1399 not included in AIM Sleep Program effective April 1, 2021

Products & Programs

Does your practice offer telehealth services? Let us know!

Administrative

HEDIS 2021 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

In-Office Assessment program

Medicare

Interactive bilingual website Taking Action for our Health

Exclusively developed for the Latino Community.
Administrative

Join Anthem in talking about racism and its impact on health

Administrative

Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services

Administrative

Make the change to digital authorization/referral and hospital admission notifications using EDI

Administrative

Maximizing efficient, high quality COVID-19 screenings

Administrative

MCG care guidelines 25th Edition

Administrative

Medical drug benefit clinical criteria updates - December 2020

Medicare

Medical drug benefit clinical criteria updates - November 2020

Medicare

Medical policy and clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

National Consumer Cost Tool (NCCT) provider cost data available for review

Administrative

New reimbursement policy: Clinic Charges - facility

Notice of material change/amendment to contract
Reimbursement Policies

Oncology dose reduction program beginning July 1, 2021

Medicare

Payer Spaces update - Education and Reference Center is now the Information Center

Administrative

Pharmacy information available on anthem.com

Pharmacy

Prior authorization updates for specialty pharmacy effective July 1, 2021

Pharmacy

Procedure searches in Find Care - new sort option

Administrative

Provider Manual to be updated July 1, 2021

Administrative

The heath of millennials: Trends in behavioral health conditions

Behavioral Health

Understanding Availity roles for Electronic Data Interchange (EDI)

Administrative

Update to provider UM reimbursement penalties and corresponding language in Provider Manual

Administrative

Update: Site of Care medical necessity reviews for long-acting colony-stimulating factors to begin August 1, 2021

Products & Programs
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