Maine
Provider Communications

Articles

Title Publication Category Date

Clinical criteria updates for specialty pharmacy

May 2020 Anthem Maine Provider News Pharmacy May 1, 2020

Clinical criteria updates for specialty pharmacy

June 2020 Anthem Maine Provider News Pharmacy Jun 1, 2020

Clinical criteria updates for specialty pharmacy

July 2020 Anthem Maine Provider News Pharmacy Jul 1, 2020

Clinical criteria updates for specialty pharmacy

August 2020 Anthem Maine Provider News Pharmacy Aug 1, 2020

Clinical Guideline CG-ANC-07 effective September 1, 2019

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Clinical guideline update effective June 1, 2020 - Paraesophageal Hernia Repair

March 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Mar 1, 2020

Clinical guideline updates are available on anthem.com

August 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Aug 1, 2018

Clinical guideline updates are available on anthem.com

October 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Oct 1, 2018

Clinical guideline updates are available on anthem.com

December 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Clinical guideline updates are available on anthem.com

January 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jan 1, 2019

Clinical guideline updates are available on anthem.com

February 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Clinical guideline updates are available on anthem.com

May 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines May 1, 2019

Clinical guideline updates are available on anthem.com

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Clinical guideline updates are available on anthem.com

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Clinical guideline updates are available on anthem.com

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

Clinical guideline updates are available on anthem.com

November 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

Clinical guideline updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical laboratory improvement amendments

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

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

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Clinical practice and preventive health guidelines available on anthem.com

June 2018 Maine newsletter Administrative Jun 19, 2018

Clinical practice and preventive health guidelines available on anthem.com

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018

Clinical practice and preventive health guidelines available on anthem.com

October 2018 Anthem Maine Provider Newsletter Administrative Oct 1, 2018

Clinical practice and preventive health guidelines available on anthem.com

December 2018 Anthem Maine Provider Newsletter Administrative Dec 1, 2018

Clinical practice and preventive health guidelines available on anthem.com

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

April 2019 Anthem Maine Provider Newsletter Administrative Apr 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

June 2019 Anthem Maine Provider Newsletter Administrative Jun 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Clinical validation - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

August 2018 Anthem Maine Provider Newsletter Medicare Aug 1, 2018

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Maine Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Coding reminder for psychological and neuropsychological testing

December 2019 Anthem Maine Provider News Behavioral Health Dec 1, 2019

Coding Updates

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Coding Updates

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Cologuard covered for Medicare Advantage members

June 2018 Maine newsletter Medicare Jun 19, 2018

Colonoscopy and related anesthesia services billing

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018

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

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Commercial drug list important updates

March 2019 Anthem Maine Provider Newsletter Pharmacy Mar 1, 2019

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

July 2020 Anthem Maine Provider News Administrative Jul 1, 2020

Commercial Risk Adjustment (CRA) Program update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Commercial Risk Adjustment (CRA) Program update: Retrospective Program begins; Prospective Program continues

June 2020 Anthem Maine Provider News Administrative Jun 1, 2020

Commercial Risk Adjustment (CRA) Prospective Program update: Assessing patients for risk adjustable conditions

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Commercial risk adjustment (CRA) reporting update

April 2019 Anthem Maine Provider Newsletter Administrative Apr 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Health Assessment requests for 2019 / Alternative reporting engagement

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Commercial Risk Adjustment (CRA) reporting update: Retrospective Program begins; benefits of direct connection access to your EMR

June 2019 Anthem Maine Provider Newsletter Administrative Jun 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program continues

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Commercial Risk Adjustment Program update: Medical chart collection for ACA members due March 31, 2019

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

ConditionCare Program benefits members and physicians

December 2018 Anthem Maine Provider Newsletter Administrative Dec 1, 2018

Continued focus on updates to public provider website

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Controlling high blood pressure

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Coordination of benefits for a Federal Employee Program® (FEP®) member

December 2018 Anthem Maine Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Coordination of benefits for an FEP® member

December 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Dec 1, 2019

Coordination of care

December 2018 Anthem Maine Provider Newsletter Administrative Dec 1, 2018

Coordination of care

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Copay reduction for walk-in center services effective January 1, 2019

November 2018 Anthem Maine Network eUpdate Administrative Nov 1, 2018

Coverage change for contraceptives and contraceptive supplies effective January 1, 2019

February 2019 Anthem Maine Provider Newsletter Administrative Feb 1, 2019

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (updated June 9, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Maine Administrative Jun 9, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Daily morphine equivalent dosing limit to apply effective September 1, 2018

August 2018 Anthem Maine Provider Newsletter Pharmacy Aug 1, 2018

Diabetes HbA1c HEDIS guidance

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

Diagnosis-Related Group Newborn Inpatient Stays facility reimbursement policy update

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

Digital Provider Enrollment application now available

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

Documentation and Reporting Guidelines for E/M Services update: professional

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Drug lists supporting commercial health plans updated

August 2018 Anthem Maine Provider Newsletter Pharmacy Aug 1, 2018

Drug Screen Testing update: professional

May 2019 Anthem Maine Provider Newsletter Reimbursement Policies May 1, 2019

Dual eligible special needs plans: provider training required

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

Durable medical equipment miscellaneous code E1399 reminder

June 2018 Maine newsletter Administrative Jun 19, 2018

Durable Medical Equipment professional reimbursement policy reminders

June 2018 Maine newsletter Reimbursement Policies Jun 22, 2018

Durable medical equipment update effective October 14, 2018

October 2018 Anthem Maine Provider Newsletter Administrative Oct 1, 2018

Easter Seals relationship expanded to support commercial members with complex needs

June 2018 Maine newsletter Products & Programs Jun 22, 2018

EDI collaboration with Availity effective June 1, 2018

June 2018 Maine newsletter Administrative Jun 19, 2018

EDI Gateway migration updates

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

Electronic attachments - X12 275 5010

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Electronic attachments coming soon

June 2019 Anthem Maine Provider Newsletter Administrative Jun 1, 2019

Electronic attachments coming soon

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Electronic claim payment reconsideration

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Electronic data interchange

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Electronic member ID cards – Easy online access on the Availity portal

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Electronic prior authorization requests for prescription medications accepted online

December 2018 Anthem Maine Provider Newsletter Pharmacy Dec 1, 2018

Enhanced process for submitting behavioral health authorization requests now available

June 2020 Anthem Maine Provider News Behavioral Health Jun 1, 2020

Enhanced search and download options allow easy access to information at your fingertips

Enhanced search and download options allow easy access to information at your fingertips - Maine Administrative Oct 8, 2019

Expansion of AIM Musculoskeletal Program effective November 1, 2020

August 2020 Anthem Maine Provider News Products & Programs Aug 1, 2020

Explore new enhancements to Availity’s Education and Reference Center

October 2018 Anthem Maine Provider Newsletter Administrative Oct 1, 2018

Explore updates to medical attachment tool

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

Eye refraction and routine eye exam billing information

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Fall prevention tips

May 2019 Anthem Maine Provider Newsletter Medicare May 1, 2019

Federal Employee Health Benefit Program® (FEP) PPO members will now require prior approval for specific specialty drugs and site of care

July 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Jul 1, 2019

Federal Employee Program® specialty pharmacy clinical site-of-care prior authorization review

October 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Oct 1, 2019

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. 
COVID-19 Information - Maine Administrative Apr 10, 2020

Find a Doctor - new sort option

June 2019 Anthem Maine Provider Newsletter Administrative Jun 1, 2019

Formulary lists updated for Anthem commercial health plan pharmacy benefit

August 2020 Anthem Maine Provider News Pharmacy Aug 1, 2020

Formulary lists updated for commercial health plans

February 2020 Anthem Maine Provider News Pharmacy Feb 1, 2020

Frequency Editing - professional

June 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jun 1, 2019

Frequency Editing Reimbursement Policy update - professional

August 2019 Anthem Maine Provider News Reimbursement Policies Aug 1, 2019

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Gestational age required for professional delivery claims effective November 1, 2018

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018
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