Ohio
Provider Communications

April 2021 Anthem Provider News - Ohio

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Title Category

New reimbursement policy: Newborn Inpatient Stays for facilities*

*Notice of Material Amendment/Change to Contract (MAC)
Reimbursement Policies

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

Pharmacy

Updates for specialty pharmacy are available - April 2021*

*Notice of Material Amendment/Change to Contract (MAC)
Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Does your practice offer telehealth services? Let us know!

Medicare

In-Office Assessment program

Medicare

Oncology dose reduction program beginning July 1, 2021

Medicare

Clinical criteria updates notification - November 2020

Medicare

Clinical criteria updates notification - December 2020

Medicare

Medical policy and clinical guideline updates - April 2021*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Update: Clinical guideline adoption postponed*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

MCG Care Guidelines 25th Edition available*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Maximizing efficient, high quality COVID-19 screenings*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

Medical Policy & Clinical Guidelines

HEDIS 2021 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

The health of millennials: Trends in behavioral health conditions

Behavioral Health

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - April 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
Administrative

COVID fee schedule changes*

*Notice of Material Amendment/Change to Contract (MAC)
Administrative

Updated Provider Manual now available

Administrative

Does your practice offer telehealth services? Let us know!

Administrative

Information Center - Access important policies, forms and helpful resources

Administrative

Understanding Availity roles for electronic data interchange (EDI)

Administrative

Make the change to digital authorization/referral and hospital admission notifications using EDI

Administrative

Attention facilities: Sending admission, discharge and transfer data results in improved care management for patients

Administrative

Chat directly with a prior authorization specialist

Administrative

Keeping up with routine vaccination during COVID-19

Administrative

Interactive bilingual website taking action for our health

Exclusively developed for the Latino Community
Administrative

Join Anthem in talking about racism and its impact on health

Administrative
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