Ohio
Provider Communications

June 2021 Anthem Provider News - Ohio

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Title Category

Answering your claims questions is easier through chat; secure messaging will sunset soon, start using chat now

Administrative

Continuation of skilled nursing facility (SNF) process in Indiana and Ohio

Medical Policy & Clinical Guidelines

DEXA bone scan criteria for the Federal Employee Program®

Federal Employee Plan (FEP)

Digital solution options with Availity

Digital Tools

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Digital Tools

Keep your contact information current

Administrative

Let’s vaccinate

Products & Programs

MCG Care Guidelines 25th Edition

Medicare

Medical policies and clinical utilization management guidelines update

Medicare

Medical policy and clinical guideline updates - June 2021*

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

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
Medicare

New Back Pain Management Program effective July 19, 2021

Medical Policy & Clinical Guidelines

Notice of changes to prior authorization requirements for Designated Specialty Pharmacy Network

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

Administrative

Prior authorization for genetic testing medical policy effective September 1, 2021*

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

Regular check-ins with your clearinghouse could affect timely filing

Administrative

Reimbursement policy reminder: Inpatient readmissions

Medicare

Reimbursement policy update: Outpatient facility claim edits

Reimbursement Policies

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

Medicare

Submit EDI corrected claims via Availity or EDI

Digital Tools

Two great learning resources on one secure portal

Digital Tools

Update to evaluation and management services correct coding - Professional

Reimbursement Policies

Updates for specialty pharmacy are available - June 2021*

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

Updates to AIM advanced imaging clinical appropriateness guidelines*

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

Updates to AIM musculoskeletal program clinical appropriateness guidelines*

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