Ohio
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Upgraded data management system launches August 2022

August 2022 Anthem Provider News - Ohio Medicare Aug 1, 2022

Keep up with Medicare News - August 2022

- MCG care guidelines 26th edition
August 2022 Anthem Provider News - Ohio Medicare Aug 1, 2022

New! Concierge Cancer Care program for Ohio Federal Employee Program members

July 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jul 1, 2022

Keep up with Medicare News - July 2022

- New specialty pharmacy medical step therapy requirements
July 2022 Anthem Provider News - Ohio Medicare Jul 1, 2022

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Anthem Provider News - Ohio Medicare Jul 1, 2022

Cancer Care Navigator

July 2022 Anthem Provider News - Ohio Medicare Jul 1, 2022

Process change for Federal Employee Program third-party correspondence requests

June 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jun 1, 2022

Keep up with Medicare News - June 2022

June 2022 Anthem Provider News - Ohio Medicare Jun 1, 2022

Evaluation and management services for COVID testing - professional

June 2022 Anthem Provider News - Ohio Medicare Jun 1, 2022

Medical drug benefit clinical criteria updates

June 2022 Anthem Provider News - Ohio Medicare Jun 1, 2022

Medical policies and clinical utilization management guidelines update

June 2022 Anthem Provider News - Ohio Medicare Jun 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

June 2022 Anthem Provider News - Ohio Medicare Jun 1, 2022

Keep up with Medicare News - May 2022

- Anthem expands specialty pharmacy precertification list-March 2022 update
- Anthem expands specialty pharmacy precertification list-April 2022 update
- New specialty pharmacy medical step therapy requirements-May 2022 update
May 2022 Anthem Provider News - Ohio Medicare May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Provider News - Ohio Medicare May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Anthem Provider News - Ohio Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements-March 2022 update

May 2022 Anthem Provider News - Ohio Medicare May 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP Quality Reimbursement Program for PPO providers

May 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) May 1, 2022

Join us for an FEP Quality Learning Program live webinar

May 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) May 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Keep up with Medicare News - April 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Anthem expands specialty pharmacy precertification list
April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Reimbursement policy update: Inpatient readmissions

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

The impact of listening

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Evaluation and management documentation guidelines

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Model of Care required training

April 2022 Anthem Provider News - Ohio Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date. Read important information about this change here.
Transition to NYC Medicare Advantage Plus Delayed - Ohio Medicare Mar 15, 2022

Change to the Federal Employee Program clinical grievance and appeal address

March 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Mar 1, 2022

Keep up with Medicare News - March 2022

- Medical step therapy updates
- Phone number change for AIM in Ohio
March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

HEDIS 2022 Federal Employee Program medical record request requirements

March 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Mar 1, 2022

Annual wellness visits for Medicare Advantage members

March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

Pharmacy: Medication adherence

March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

Evaluation and management services correct coding reminder (professional)

March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

Clinical criteria updates

March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

Provider notification for utilization management authorization rule operations workgroup item 2662

March 2022 Anthem Provider News - Ohio Medicare Mar 1, 2022

Keep up with Medicare News - February 2022

- NYC Medicare Advantage Plus update
February 2022 Anthem Provider News - Ohio Medicare Feb 1, 2022

Get faster payments with EFT

February 2022 Anthem Provider News - Ohio Medicare Feb 1, 2022

2022 FEP benefit information available online

January 2022 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2022

Keep up with Medicare News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
- Medical step therapy updates
- Anthem expands specialty pharmacy precertification list
January 2022 Anthem Provider News - Ohio Medicare Jan 1, 2022

Professional claims: Billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

January 2022 Anthem Provider News - Ohio Medicare Jan 1, 2022

Important update on Botox® for Anthem Medicare members

January 2022 Anthem Provider News - Ohio Medicare Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Ohio Medicare Jan 1, 2022

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Keep up with Medicare News - December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Reimbursement policy update: Drug screen testing

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Somatus is your resource for kidney care management

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Anthem Provider News - Ohio Medicare Dec 1, 2021

Keep up with Medicare News - November 2021

View these Medicare articles:
- Anthem expands specialty pharmacy prior authorization list
November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

Anthem offering Advance Medical Directives program for 2022

November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

New York City Medicare Advantage announcement

November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Ohio Medicare Nov 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

Keep up with Medicare news - October 2021

View these Medicare articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

HEDIS medical record submission made easier with our Remote EMR Access Service

October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

New medical step therapy requirements

October 2021 Anthem Provider News - Ohio Medicare Oct 1, 2021

Keep up with Medicare news - September 2021

View this Medicare article:
- Clinical criteria updates notification – May 2021

 

September 2021 Anthem Provider News - Ohio Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers

September 2021 Anthem Provider News - Ohio Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Anthem Provider News - Ohio Medicare Sep 1, 2021

Prior authorization form notification

September 2021 Anthem Provider News - Ohio Medicare Sep 1, 2021

Change in email submission of service requests for Federal Employee Program® members*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Aug 1, 2021

Medicare News - August 2021

View these Medicare articles:
- Infliximab Step Therapy - Effective 7/15/2021
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907
August 2021 Anthem Provider News - Ohio Medicare Aug 1, 2021

Preventing claims denials: Shingles vaccine

August 2021 Anthem Provider News - Ohio Medicare Aug 1, 2021

Medicare News - July 2021

View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

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

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

DEXA bone scan criteria for the Federal Employee Program®

June 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Ohio Medicare Jun 1, 2021

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
June 2021 Anthem Provider News - Ohio Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Provider News - Ohio Medicare Jun 1, 2021

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

June 2021 Anthem Provider News - Ohio Medicare Jun 1, 2021

Reimbursement policy reminder: Inpatient readmissions

June 2021 Anthem Provider News - Ohio Medicare Jun 1, 2021

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines
May 2021 Anthem Provider News - Ohio Medicare May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Ohio Medicare May 1, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Clinical criteria updates notification - November 2020

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Clinical criteria updates notification - December 2020

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Medical policies and clinical utilization management guidelines update

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

PN for UM AROW Item 1330

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2021

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

2020 Medicare risk adjustment provider trainings

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021
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