New Hampshire
Provider Communications

November 2019 Anthem New Hampshire Provider News

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Title Category

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

Products & Programs

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Products & Programs

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

Products & Programs

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guidelines

Products & Programs

Reminder: new AIM Rehabilitative Program effective November 1, 2019

Administrative

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Reimbursement Policy update: Drug Screen Testing

Medicare

Rehabilitative services prior authorization review update for Medicare Advantage members

Medicare

Pre-service clinical review and quantity limit updates for specialty pharmacy effective February 1, 2020

Pharmacy

Modifier use reminders

Administrative

Medical policy updates are available on anthem.com

Medical Policy & Clinical Guidelines

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

Medicare

CMS reminder: expedited/urgent requests

Medicare

Clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

Clinical criteria updates for specialty pharmacy

Pharmacy

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

Medicare

Bill Medicare Part D for shingles or tetanus vaccination claims

Medicare

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

Additional improvements coming to anthem.com

Administrative

2019 Enhanced Personal Health Care Program releases myFHR

Medicare
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