Ohio
Provider Communications

August 2019 Anthem Provider News - Ohio

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Title Category

New location for Provider Manuals on anthem.com

Administrative

Update: Sepsis Coding

Administrative

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- August 2019

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

Medical Policy and Clinical Guideline Updates -- August 2019*

Medical Policy & Clinical Guidelines

Anthem customizations to MCG care guidelines 23rd edition*

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

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

Medicare News -- August 2019

Medicare

New service types added to Availity

Medicare

New Reimbursement Policy: Drug Screen Testing

Medicare

AIM Specialty Health programs may require documentation

Medicare

Special needs plans - provider training required

Medicare

Clinical criteria and prior authorization updates for specialty pharmacy are available*

Pharmacy

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

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Reimbursement Policy Update: Bundled Services-Professional*

Reimbursement Policies

Reimbursement Policy Update: Frequency Editing-Professional*

Reimbursement Policies
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