Ohio
Provider Communications

July 2019 Anthem Provider News - Ohio

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Title Category

Reminder to providers: Fee schedule information

Administrative

Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*

Administrative

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

Administrative

Make the move to the Availity EDI Gateway today

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression -- What’s in it for you and your patients?

Administrative

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

Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

Federal Employee Plan (FEP)

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Outpatient Rehabilitation Program transitioning to AIM

Medicare

Medical Policies and Clinical Utilization Management Guidelines update -- July 2019

Medicare

Home health billing guidelines for contracted providers

Medicare

Sepsis diagnosis coding and billing reminder

Medicare

Keep up with Medicare News -- July 2019

Medicare

Clinical Criteria coding updates for specialty pharmacy are available

Pharmacy

Clinical criteria updates for specialty pharmacy

Pharmacy

Clinical Validation: Professional*

Reimbursement Policies

Modifier 79 reminder: Professional

Reimbursement Policies

Modifier 63 reminder: Professional

Reimbursement Policies

ICD-10-CM Coding Guidelines and Laterality: Professional

Reimbursement Policies
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