Nevada
Provider Communications

August 2019 Anthem Provider News and Important Updates - Nevada

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Title Category

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

AIM Specialty Health programs may require documentation

Medicare

Anthem customizations to MCG care guidelines 23rd edition (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Anthem launches additional changes to anthem.com for Provider Manuals

Administrative

Bundled Services (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
Pharmacy

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Keep up with Medicaid news

Medicaid

Keep up with Medicare news

Medicare

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

New Reimbursement Policy: Drug Screen Testing

Medicare

New service types added to Availity

Medicare

New service types added to Availity

Medicaid

Non-participating lab referrals

Administrative

Pharmacy information available on anthem.com

Pharmacy

Pharmacy management information

Medicaid

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

Administrative

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

Pharmacy

Special needs plans -- provider training required

Medicare

Update your information

Medicaid

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Working with Anthem Webinars - August 2019 schedule: Networks Overview -- rescheduled from July

Administrative
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