Maine
Provider Communications

Articles

Title Publication Category Date

Sepsis coding update

June 2019 Anthem Maine Provider Newsletter Administrative Jun 1, 2019

Scope of License reimbursement policy update: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Routine Obstetrical Services update: professional

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

Risk adjustment and documentation training offered

January 2019 Anthem Maine Provider Newsletter Medicare Jan 1, 2019

Review of reimbursement policies – professional

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

Review of professional claims with emergency room level 5 E/M codes

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Maine Provider Newsletter Medicare Jun 1, 2019

Retrieve Anthem member HEDIS® care gaps through Patient360 on the Availity Portal

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

December 2018 Anthem Maine Provider Newsletter Products & Programs Dec 1, 2018

Resources to support diverse patients and communities

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Reminder: review ICD-10-CM coding guidelines: professional

February 2019 Anthem Maine Provider Newsletter Administrative Feb 1, 2019

Reminder: refer Medicare Advantage members to in-network providers

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Reminder: Process change for medical non-oncology specialty drug reviews effective June 15, 2019

August 2019 Anthem Maine Provider News Pharmacy Aug 1, 2019

Reminder: non-physical, occupational or speech therapists must include modifiers on physical, occupational, or speech therapy claims

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Reminder: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Maine Provider News Administrative Nov 1, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Maine Provider News Products & Programs Dec 1, 2019

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Reminder: HCPCS code A0998 is active and available for use

January 2019 Anthem Maine Provider Newsletter Administrative Jan 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Reminder: Anthem follows Original Medicare policies

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Maine Provider Newsletter Products & Programs Jun 1, 2019

Reminder about system updates

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Reminder - New ID cards for many Anthem members

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

November 2019 Anthem Maine Provider News Pharmacy Nov 1, 2019

Reimbursement policy update: Frequency Editing - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement Policy update: Drug Screen Testing

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Reimbursement policy update: Distinct Procedural Services - Modifiers 59, XE, XP, XS, XU - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Claims Requiring Additional Documentation (facility)

May 2020 Anthem Maine Provider News Reimbursement Policies May 1, 2020

Reimbursement Policy update - Place of Service – professional

October 2019 Anthem Maine Provider News Reimbursement Policies Oct 1, 2019

Reimbursement policy update - Claims Requiring Additional Documentation (facility)

August 2020 Anthem Maine Provider News Reimbursement Policies Aug 1, 2020

Reimbursement for select HEDIS related CPT II codes for Medicare Advantage members coming soon

April 2019 Anthem Maine Provider Newsletter Medicare Apr 1, 2019

Reimbursement for convenience surgical supply kits: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Rehabilitative services prior authorization review update for Medicare Advantage members

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Referring to contracted ambulance providers

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Receive direct deposit of patient payments with Healthcare Bill Payments

June 2018 Maine newsletter Administrative Jun 19, 2018

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Receive and respond to medical record requests for postpay audit via Change Healthcare’s Assurance Attach Assist Module

September 2020 Anthem Maine Provider News Administrative Sep 1, 2020

Readmissions Reimbursement Policy update: facility

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

Quality Corner: CPT® Category II codes - Collaborating for enhanced patient care

June 2020 Anthem Maine Provider News Administrative Jun 1, 2020

Quality Corner - Follow-Up after Hospitalization for Mental Illness

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

Quality Corner - Diabetes HbA1c<8 HEDIS guidance

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Provider Transparency Update

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018

Provider transparency update

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Provider transparency update

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Provider Manual to be updated July 1, 2020

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Provider Manual to be updated July 1, 2020

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Provider manual to be updated July 1, 2019

April 2019 Anthem Maine Provider Newsletter Administrative Apr 1, 2019

Provider manual to be updated July 1, 2019

May 2019 Anthem Maine Provider Newsletter Administrative May 1, 2019

Provider Manual to be available on anthem.com June 1, 2018

June 2018 Maine newsletter Administrative Jun 22, 2018

Provider Maintenance Form (PMF) enhancement

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

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

August 2020 Anthem Maine Provider News Administrative Aug 1, 2020

Prior authorization updates for specialty pharmacy effective September 1, 2020

June 2020 Anthem Maine Provider News Pharmacy Jun 1, 2020

Prior authorization updates for specialty pharmacy effective October 1, 2020

July 2020 Anthem Maine Provider News Pharmacy Jul 1, 2020

Prior authorization updates for specialty pharmacy effective November 1, 2020

August 2020 Anthem Maine Provider News Pharmacy Aug 1, 2020

Prior authorization requirements for E0784, K0553 and K0554

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Prior authorization requirements for continuous positive airway pressure supplies

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Prior authorization requests for prescription medications accepted online

June 2018 Maine newsletter Pharmacy Jun 19, 2018

Prior authorization requests for prescription medications accepted online

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018

Prior authorization requests for prescription medications accepted online

October 2018 Anthem Maine Provider Newsletter Pharmacy Oct 1, 2018

Prior authorization for BiPAP equipment and supplies moving from AIM Specialty Health effective July 1, 2020

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

Precertification request turnaround times for the Federal Employee Program

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

Pre-service clinical review drug list changes effective September 1, 2018

June 2018 Maine newsletter Administrative Jun 19, 2018

Pre-service clinical review drug list changes effective November 1, 2018

August 2018 Anthem Maine Provider Newsletter Pharmacy Aug 1, 2018

Pre-service clinical review and quantity limit updates for specialty pharmacy effective February 1, 2020

November 2019 Anthem Maine Provider News Pharmacy Nov 1, 2019

Postponed: review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Postponed - review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Please evaluate statin use for MA members with diabetes, cardiovascular disease

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Pharmacy information available on anthem.com

June 2018 Maine newsletter Pharmacy Jun 22, 2018

Pharmacy information available on anthem.com

August 2018 Anthem Maine Provider Newsletter Pharmacy Aug 1, 2018

Pharmacy information available on anthem.com

October 2018 Anthem Maine Provider Newsletter Pharmacy Oct 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Maine Provider Newsletter Pharmacy Dec 1, 2018

Pharmacy information available on anthem.com

March 2019 Anthem Maine Provider Newsletter Pharmacy Mar 1, 2019

Pharmacy information available on anthem.com

April 2019 Anthem Maine Provider Newsletter Pharmacy Apr 1, 2019

Pharmacy information available on anthem.com

May 2019 Anthem Maine Provider Newsletter Pharmacy May 1, 2019

Pharmacy information available on anthem.com

June 2019 Anthem Maine Provider Newsletter Pharmacy Jun 1, 2019

Pharmacy information available on anthem.com

August 2019 Anthem Maine Provider News Pharmacy Aug 1, 2019

Pharmacy information available on anthem.com

October 2019 Anthem Maine Provider News Pharmacy Oct 1, 2019

Pharmacy information available on anthem.com

December 2019 Anthem Maine Provider News Pharmacy Dec 1, 2019

Pharmacy information available on anthem.com

March 2020 Anthem Maine Provider News Pharmacy Mar 1, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Maine Provider News Pharmacy Apr 1, 2020

Pharmacy information available on anthem.com

June 2020 Anthem Maine Provider News Pharmacy Jun 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Maine Provider News Pharmacy Aug 1, 2020

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Penalties for late pre-certification update

August 2018 Anthem Maine Provider Newsletter Administrative Aug 1, 2018

Peer-to-peer process can help clarify clinical record

June 2018 Maine newsletter Medicare Jun 19, 2018

PCP after-hours access requirements

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Payment recovery process simplified for National Accounts membership

December 2018 Anthem Maine Provider Newsletter Administrative Dec 1, 2018

Payment recovery process simplified for National Accounts membership

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Payment recovery process simplified for National Accounts membership

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Patient360 enhancement for medical providers

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Patient360 adds care gap alert feedback for medical providers

September 2020 Anthem Maine Provider News Administrative Sep 1, 2020

Partial hospitalization services

May 2019 Anthem Maine Provider Newsletter Medicare May 1, 2019

Outpatient/office physical, speech, and occupational therapy claim form requirements

December 2018 Anthem Maine Provider Newsletter Administrative Dec 1, 2018

Outpatient/office physical, speech, and occupational therapy claim form requirements

March 2019 Anthem Maine Provider Newsletter Administrative Mar 1, 2019

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Outpatient Rehabilitation Program transition: new prior authorization requirements effective April 1, 2020

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

Outpatient facility edit implementation effective April 26, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Outpatient behavioral health therapy visits

June 2018 Maine newsletter Behavioral Health Jun 19, 2018

Optum to collect medical records for risk adjustment

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020
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