Nevada
Provider Communications

June 2020 Anthem Provider News and Important Updates -- Nevada

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Title Category

2020 Medicare risk adjustment provider trainings

Medicare

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
Administrative

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

Medicare

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

Administrative

Anthem enhances process for submitting Behavioral Health Authorizations

Behavioral Health

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Administrative

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
Pharmacy

Availity Portal Notification Center

Administrative

Diabetes HbA1c < 8 HEDIS guidance

Medicare

Follow-Up After Hospitalization for Mental Illness

Medicaid

Keep up with Medicaid news

Medicaid

Keep up with Medicare news

Medicare

Modifier use reminders

Medicare

Notification for ambulatory medical record review

Medicaid

Nurse Practitioner and Physician Assistant Service (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Pharmacy information available on anthem.com

Pharmacy

Quality Corner: Follow-Up after Hospitalization for Mental Illness

Behavioral Health

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

Administrative

Resources supporting our providers during COVID-19

Medicaid

Transition to AIM Clinical Appropriateness Guidelines -- Rehabilitative Services (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

Products & Programs

Updated Escalation Contact List -- Nevada

Administrative

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medicare
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