Missouri
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

2019 Medicare Advantage individual benefits and formularies

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

2020 affirmative statement concerning utilization management decisions

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

2020 Medicare risk adjustment provider trainings

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News - Missouri Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News - Missouri Medicare Aug 1, 2019

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Missouri Provider Newsletter Medicare Feb 1, 2019

Anthem offers risk adjustment and documentation training

January 2019 Anthem Missouri Provider Newsletter Medicare Jan 1, 2019

Anthem transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

October 2018 Anthem Missouri Provider Newsletter Medicare Sep 28, 2018

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

August 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Provider News - Missouri Medicare Nov 1, 2019

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Anthem Provider Newsletter - Missouri Medicare Mar 1, 2019

Changes to prior authorization (PA) requirements

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Provider Newsletter - Missouri Medicare Mar 1, 2019

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Missouri Medicare Nov 1, 2019

Coming soon: Electronic attachments

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Anthem Provider Newsletter - Missouri Medicare Apr 1, 2019

Complex discharge planning

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Missouri Medicare Apr 1, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Dual Eligible Special Needs (D-SNP) Plans - provider training required

March 2019 Anthem Provider Newsletter - Missouri Medicare Mar 1, 2019

Electric Boat offers Medicare Advantage options

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

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

October 2018 Anthem Missouri Provider Newsletter Medicare Sep 28, 2018

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News - Missouri Medicare Jul 1, 2019

In-Office Assessment Program

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Anthem Provider Newsletter - Missouri Medicare Mar 1, 2019

Introducing ConcertoHealth

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

IUOE 513 Welfare Fund moves to Anthem Medicare Preferred (PPO) medical plan

September 2020 Anthem Provider News - Missouri Medicare Sep 1, 2020

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

Keep up with Medicare news

October 2018 Anthem Missouri Provider Newsletter Medicare Sep 28, 2018

Keep up with Medicare news

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

Keep up with Medicare news

January 2019 Anthem Missouri Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

February 2019 Anthem Missouri Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

March 2019 Anthem Provider Newsletter - Missouri Medicare Mar 1, 2019

Keep up with Medicare news - April 2019

April 2019 Anthem Provider Newsletter - Missouri Medicare Apr 1, 2019

Keep up with Medicare news - May 2019

May 2019 Anthem Provider Newsletter - Missouri Medicare May 1, 2019

Keep up with Medicare News -- July 2019

July 2019 Anthem Provider News - Missouri Medicare Jul 1, 2019

Keep up with Medicare News -- June 2019

June 2019 Anthem Provider Newsletter - Missouri Medicare Jun 1, 2019

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Missouri Medicare Sep 1, 2020

Medical drug benefit Clinical Criteria updates - December 2019

April 2020 Anthem Provider News - Missouri Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

April 2020 Anthem Provider News - Missouri Medicare Apr 1, 2020

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Missouri Medicare Dec 1, 2019

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Missouri Provider Newsletter Medicare Jan 1, 2019

Medicare News - April 2020

View these Medicare notices:
- Coding tip for psychological and neuropsychological testing
- Medical Policies and Clinical Utilization Management Guidelines update
- New Medicare Advantage opioid treatment Program benefit
- Prior authorization requirements: new 2020 codes for coverage and precertification
April 2020 Anthem Provider News - Missouri Medicare Apr 1, 2020

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

Medicare News - February 2020

February 2020 Anthem Provider News - Missouri Medicare Feb 1, 2020

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Medicare News - March 2020

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

Medicare News -- August 2019

August 2019 Anthem Provider News - Missouri Medicare Aug 1, 2019

Medicare News -- December 2019

December 2019 Anthem Provider News - Missouri Medicare Dec 1, 2019

Medicare News -- January 2020

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Medicare News -- November 2019

November 2019 Anthem Provider News - Missouri Medicare Nov 1, 2019

Medicare News -- October 2019

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

Medicare News -- September 2019

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

Medicare pharmacy and prescriber home starts January 2019

October 2018 Anthem Missouri Provider Newsletter Medicare Sep 28, 2018

Medicare preferred continuous glucose monitors

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Provider News - Missouri Medicare Feb 1, 2020

New Medicare Advantage provider service phone number beginning January 1, 2019

December 2018 Anthem Missouri Provider Newsletter Medicare Dec 1, 2018

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News - Missouri Medicare Aug 1, 2019

New service types added to Availity

Anthem Missouri UPDATE: Important Reminder - City of St. Louis Police Medicare Aug 1, 2019

New specialty Medicare Part B device preferred product program

February 2019 Anthem Missouri Provider Newsletter Medicare Feb 1, 2019

Non-preferred products and corresponding preferred alternatives

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

Ozarks Schools Benefits Association, MO moves to Anthem Medicare Advantage plan

April 2019 Anthem Provider Newsletter - Missouri Medicare Apr 1, 2019

Personal Home Helper benefit

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News - Missouri Medicare Sep 1, 2019

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

October 2018 Anthem Missouri Provider Newsletter Medicare Sep 28, 2018

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

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News - Missouri Medicare Oct 1, 2019

Provider training series

December 2019 Anthem Provider News - Missouri Medicare Dec 1, 2019

Reimbursement Policy Update: Modifier 62: Co-Surgeons

February 2020 Anthem Provider News - Missouri Medicare Feb 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

Reminder to Medicare Advantage providers

December 2019 Anthem Provider News - Missouri Medicare Dec 1, 2019

Reminder: Anthem follows Original Medicare policies

February 2019 Anthem Missouri Provider Newsletter Medicare Feb 1, 2019

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

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Reminder: Mid-level practitioners are required to file using their NPI

March 2020 Anthem Provider News - Missouri Medicare Mar 1, 2020

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

June 2019 Anthem Provider Newsletter - Missouri Medicare Jun 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News - Missouri Medicare Jul 1, 2019

September 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Missouri Medicare Jan 1, 2020

Special needs plans - provider training required

August 2019 Anthem Provider News - Missouri Medicare Aug 1, 2019
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