Ohio
Provider Communications

August 2019 Anthem Provider News - Ohio

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Title Category

AIM Specialty Health programs may require documentation

Medicare

Anthem customizations to MCG care guidelines 23rd edition*

Medical Policy & Clinical Guidelines

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

Pharmacy

Medical Policy and Clinical Guideline Updates -- August 2019*

Medical Policy & Clinical Guidelines

Medicare News -- August 2019

Medicare

New location for Provider Manuals on anthem.com

Administrative

New Reimbursement Policy: Drug Screen Testing

Medicare

New service types added to Availity

Medicare

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

Pharmacy information available at anthem.com

Pharmacy

Reimbursement Policy Update: Bundled Services-Professional*

Reimbursement Policies

Reimbursement Policy Update: Frequency Editing-Professional*

Reimbursement Policies

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

Pharmacy

Special needs plans - provider training required

Medicare

Update: Sepsis Coding

Administrative

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
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