Maine
Provider Communications

August 2020 Anthem Maine Provider News

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Title Category

Coming soon - Interactive Care Reviewer Anthem’s self-service online prior authorization tool

Administrative

Reminder - New ID cards for many Anthem members

Administrative

Migrate your EDI transactions to Availity today

Administrative

Clinical Laboratory Improvement Amendments (CLIA) ID number required for electronic claims submissions

Administrative

Electronic attachments - X12 275 5010

Administrative

Prior Authorization/Referral Request and Inpatient Admission/Discharge Notification transactions coming soon

Administrative

Medical record standards

Administrative

Resources to support diverse patients and communities

Administrative

Appropriate coding helps provide a comprehensive picture of members’ health

Administrative

Medical drug benefit clinical criteria updates

Medicare

New MCG Care Guidelines 24th edition

Medicare

AIM Musculoskeletal Program expansion

Medicare

2020 Medicare risk adjustment provider trainings

Medicare

Keep up with Medicare news

Medicare

Formulary lists updated for Anthem commercial health plan pharmacy benefit

Pharmacy

Clinical criteria updates for specialty pharmacy

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Prior authorization updates for specialty pharmacy effective November 1, 2020

Pharmacy

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

Products & Programs

Expansion of AIM Musculoskeletal Program effective November 1, 2020

Products & Programs

Reimbursement policy update - Claims Requiring Additional Documentation (facility)

Reimbursement Policies
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