Nevada
Provider Communications

Articles

Title Publication Category Date

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

June 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jun 1, 2020

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

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jun 1, 2020

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

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Resources supporting our providers during COVID-19

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Keep up with Medicare news

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Notification for ambulatory medical record review

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Keep up with Medicaid news

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Nevada Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Nevada Administrative May 29, 2020

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

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Nevada Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Nevada Administrative May 1, 2020

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

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Reminder about System Updates

May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

Keep up with Medicare news

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

COVID-19 information repository for Anthem care Providers

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Non-participating lab referrals

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Pre-Service/Prior Authorization Clinical Review Update -- May 2020 (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

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

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Sleep Disorder Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- MSK Interventional Pain Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Claims requiring additional documentation (Facility Reimbursement Policy -- Update for Inpatient and Outpatient) (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Disease Management can help you care for patients with chronic health care needs

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Medical drug benefit Clinical Criteria updates December 2019

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Postpartum incentives

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

CPT II obstetrical billing information

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Keep up with Medicaid news

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Nevada Administrative Apr 10, 2020

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

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Anthem to delay most April 1, 2020 formulary list updates for commercial health plan pharmacy benefit

April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Information from Anthem for Care Providers about COVID-19

Bookmark Provider News Home for the latest information for Care Providers about COVID-19.
April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

REMINDER: New AIM Rehabilitative Program effective April 1, 2020

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

Laboratory Medicine Consultants is no longer a Participating Provider effective April 1, 2020

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

Drug fee schedule update

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

Provider Transparency Update

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition (MAC)

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Apr 1, 2020

Anthem continues focus on updates to our public provider website

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical record request requirements

April 2020 Anthem Provider News and Important Updates -- Nevada Federal Employee Plan (FEP) Apr 1, 2020

COVID-19 Virus Talking Points - Medicare

April 2020 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for November 2019

April 2020 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for December 2019

April 2020 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2020

COVID-19 Virus Talking Points - Medicaid

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

Keep up with Medicare news

April 2020 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates for November 2019

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

Use of Imaging Studies for Low Back Pain (LBP)

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

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

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

Coding spotlight: HIV and AIDS

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

Keep up with Medicaid news

April 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2020

Updated COVID-19 Medicare and Medicaid Information

For the latest COVID-19 Medicare and Medicaid information, please check Medicaid Provider News - COVID-19
and Medicare Advantage Provider News Archives.
COVID-19 Information - Nevada State & Federal Mar 25, 2020

Anthem acquires Beacon Health Options

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 2, 2020

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020 (MAC)

Material Adverse Change (MAC)
March 2020 Anthem Provider News and Important Updates -- Nevada Products & Programs Mar 1, 2020

Pharmacy information available on anthem.com

March 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Mar 1, 2020

Provider News site enhancements

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Commercial Risk Adjustment (CRA) Program Update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Modifier use reminders

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Updated Escalation Contact List -- Nevada

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Important coding reminder for Walk-In Retail Health Clinics

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Patient360 enhancement for medical providers

March 2020 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG -- W0163 Pelvic Organ Prolapse Repair

March 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements

March 2020 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2020

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

March 2020 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2020

Nonpreferred products and corresponding preferred alternatives

March 2020 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2020

Keep up with Medicare news

March 2020 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2020

Improving the patient experience

March 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2020

Medical drug benefit Clinical Criteria updates

March 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2020

Keep up with Medicaid news

March 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2020

UPDATE: New AIM Rehabilitative Program effective April 1, 2020

February 2020 Anthem Provider News and Important Updates - Nevada Administrative Feb 1, 2020

Pre-Service/Prior Authorization Clinical Review Update -- February 2020 (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program: Joint Surgery and Spine Surgery (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

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

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical Laboratory Improvement Amendments (CLIA) claim requirements effective May 1, 2020 (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Feb 1, 2020

Verifying and updating your provider information

February 2020 Anthem Provider News and Important Updates - Nevada Medicare Feb 1, 2020

Keep up with Medicare news

February 2020 Anthem Provider News and Important Updates - Nevada Medicare Feb 1, 2020

Verifying and updating your provider information

February 2020 Anthem Provider News and Important Updates - Nevada Medicaid Feb 1, 2020

Coding spotlight: provider’s guide to coding respiratory

February 2020 Anthem Provider News and Important Updates - Nevada Medicaid Feb 1, 2020

Resources to support your diverse patient panel

February 2020 Anthem Provider News and Important Updates - Nevada Medicaid Feb 1, 2020

Keep up with Medicaid news

February 2020 Anthem Provider News and Important Updates - Nevada Medicaid Feb 1, 2020

Shine Light on Depression school-based suicide prevention initiative

February 2020 Anthem Provider News and Important Updates - Nevada Behavioral Health Feb 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2020 Anthem Provider News and Important Updates - Nevada Pharmacy Feb 1, 2020

Anthem SOAP Notes/Health Assessments for 2019 calendar year are due February 15, 2020

February 2020 Anthem Provider News and Important Updates - Nevada Administrative Feb 1, 2020

Reimbursement Policy Update Modifier 62: Co-Surgeons

February 2020 Anthem Provider News and Important Updates - Nevada Medicare Feb 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Provider News and Important Updates - Nevada Medicare Feb 1, 2020

New CMS Code Updates Effective January 1, 2020

New CMS Code Updates Effective January 1, 2020 Administrative Jan 13, 2020

New Guided Access HMO Effective January 1, 2020

New Guided Access HMO Effective January 1, 2020 - Nevada Administrative Jan 13, 2020

Western Pathology Consultants is no longer a Participating Provider

January 2020 Anthem Provider News and Important Updates - Nevada Administrative Jan 1, 2020
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