Nevada
Provider Communications

August 2018 Anthem Provider Newsletter - NV

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Title Category

2018 Utilization Management Affirmative Statement concerning utilization management decisions

Medicaid

Additional Support Available for Members with Rare Conditions

Products & Programs

Anthem accepts pre-certification requests for prescription medications online

Administrative

Anthem applies daily morphine equivalent dosing limit

Pharmacy

Anthem has partnered with Availity to become our designated EDI Gateway

Administrative

Anthem removes drugs from specialty pharmacy clinical site of care (level of care) drug list

Pharmacy

Anthem to enhance automated claim edits for professional claims

Administrative

Anthem to update drug lists supporting commercial health plans

Pharmacy

Anthem’s Individualized Care Program supports palliative care for commercial members

Products & Programs

Availity webinars regarding EDI

Administrative

Bundled Services and Supplies – Professional

Reimbursement Policies

Care and Cost Finder – New Sort Option

Administrative

Clear Claim Connection

Reimbursement Policies

Clinical Utilization Management Guidelines update

Medicaid

Electronic Data Interchange migration to Availity

Medicaid

Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)

Administrative

Important information about billing colonoscopy and related anesthesia services

Administrative

Important information about utilization management

Medicaid

Innovative ways to improve your patients’ experiences and earn CME credits

Administrative

Keep up with Medicare news

Medicare

MA members receive incentives for completing screenings

Medicare

Mailing Address for Federal Employee Program® (FEP) Paper Claims and Claims Related Correspondence

Federal Employee Plan (FEP)

Medical Policies update

Medicaid

Member Explanation of Benefits gets a makeover

Administrative

Members’ Rights and Responsibilities Statement

Medicaid

Network Update newsletter has a new look and usability features

Administrative

New enhancements to the Interactive Care Reviewer (ICR) tool

Administrative

Non-participating lab referrals

Administrative

Once per Lifetime Procedures – Professional

Reimbursement Policies

Pharmacy information available on anthem.com

Pharmacy

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

Administrative

Provider Transparency Update

Administrative

Reimbursement Policies are available online

Reimbursement Policies

Reimbursement Policy Update: Medical Recalls

Medicaid

Submit Prior Authorizations medication requests electronically; new phone and fax numbers for MA prescription PAs effective September 1

Medicare

Updated Prefix Reference List

Administrative

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web

Administrative

Working with Anthem – 2018 Subject Specific Webinars – August schedule

Administrative
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