Missouri
Provider Communications

May 2021 Anthem Provider News - Missouri

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Title Category

2021 Affirmative statement regarding utilization management decisions

Administrative

A helpful and complete guide to covered well-child visits

Administrative

Digital online scheduling feature now available in the Availity Portal

Administrative

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines
Medicare

Maximizing efficient, high quality COVID-19 screenings

Medicare

May is National High Blood Pressure Education Month

Administrative

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

Medical Policy & Clinical Guidelines

New prior authorization requirement: Kidney transplantation

Medical Policy & Clinical Guidelines

Provider bulletins for medical and itemized bill attachments: Electronic solutions at your fingertips

Administrative

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

Administrative

Reimbursement policy reminder: Readmission - Facility

Reimbursement Policies

Reimbursement policy update: Frequency editing - Professional

Reimbursement Policies

Reimbursement policy update: Claims Requiring Additional Documentation - Facility

Reimbursement Policies

Resources to support diverse patients and communities

Administrative

Sending larger digital attachments through Availity

Administrative

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization

Pharmacy

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews

Medical Policy & Clinical Guidelines

Updates for specialty pharmacy are available - May 2021

Pharmacy
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