Ohio
Provider Communications

Articles

Title Publication Category Date

Reimbursement policy update: Bundled services and supplies (Professional)*

December 2020 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2020

Clinical Validation: Professional*

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Reimbursement Policy Update: Bundled Services-Professional*

August 2019 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2019

Reimbursement Policy Update: Frequency Editing-Professional*

August 2019 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2019

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

New reimbursement policy: Newborn Inpatient Stays for facilities*

*Notice of Material Amendment/Change to Contract (MAC)
April 2021 Anthem Provider News - Ohio Reimbursement Policies Apr 1, 2021

Outpatient Facility Edit Implementation*

January 2020 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2020

Reimbursement policy update: Frequency editing - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Integrated Medical and Behavioral Healthcare Services Billing

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Tips for billing CPT modifier 33

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

New Reimbursement Policy - Facility Revenue Code Billing

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Reimbursement Policy Update - Readmissions (Facility)

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

View reimbursement policies online at anthem.com

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Claims editing update for ICD-10-CM Excludes 1 notes

March 2021 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2021

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

May 2020 Anthem Provider News - Ohio Reimbursement Policies May 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)*

June 2020 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Ohio Reimbursement Policies May 1, 2020

Update regarding E/M with modifier 25 - Professional*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

New Reimbursement Policies: Durable Medical Equipment, Rent to Purchase Durable Medical Equipment, and Modifiers (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

Update to evaluation and management services correct coding - Professional

June 2021 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2021

System updates for 2020 (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

Reimbursement policy update: Emergency department - leveling of Evaluation and Management services (Facility)*

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and venipuncture (Professional)*

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Claims requiring additional documentation policy (Facility)

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Outpatient facility claim edits

June 2021 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2021

Reimbursement Policy Updates: February 2019*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

Reimbursement Policy Update: Injectable Substances with Related Injection Services - Professional*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

New Reimbursement Policy: Ambulance Transportation -- Professional*

June 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Jun 1, 2019

Reimbursement Policy Update: Frequency Editing -- Professional*

June 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Jun 1, 2019

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

Reimbursement policy update: Sexually transmitted infections testing - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

New reimbursement policy: Non-patient laboratory services - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

New reimbursement policy update: Inpatient Facility Transfers - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Consultations - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

Update: Drug Screen Testing - Professional*

May 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies May 1, 2019

Reimbursement policy update: Drug Screen Testing - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

Reminder: HCPCS code A0998 Ambulance response and treatment with no transport is active and available for use

January 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Jan 1, 2019

Reimbursement policy update: Virtual Visits (Professional and Facility)*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Claims requiring additional documentation (Facility)*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

New reimbursement policy: Documentation standards for episodes of care (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Modifier rules (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Multiple diagnostic imaging facility (Facility)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Bundled Services and Supplies (Professional)

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

September 2020 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2020

Reimbursement for Convenience Surgical Supply Kits: Professional

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Frequency Editing (Professional)*

September 2020 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2020

View reimbursement policies online at anthem.com

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Updates - December 2018

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Update - Scope of License (Professional)

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Emergency Room Transfers - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

Reimbursement Policy update: Place of Service-Professional*

October 2019 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2019

Reimbursement Policy Update - Claims requiring additional documentation (Facility)

September 2018 Anthem Ohio eUpdate Reimbursement Policies Aug 30, 2018

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

April 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Apr 1, 2019

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

August 2020 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2020

Let’s vaccinate

June 2021 Anthem Provider News - Ohio Products & Programs Jun 1, 2021

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News - Ohio Products & Programs Jun 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Ohio Products & Programs Jul 1, 2020

Update to AIM Specialty Health clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health sleep disorder management clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Anthem fights opioid addiction: Extension for Community Healthcare Outcomes and Quality Medication-Assisted Therapy

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Health Care Reform (including Health Insurance Exchange) Updates and Notifications

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

New Musculoskeletal and Pain Management Solution Effective for Select National ASO Accounts January 1, 2020

January 2020 Anthem Provider News - Ohio Products & Programs Jan 1, 2020

Changes in Automotive Accounts AIM Processing effective Jan. 1

Dec. 14, 2018 Anthem Ohio Network eUpdate Products & Programs Dec 14, 2018

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

October 2020 Anthem Provider News - Ohio Products & Programs Oct 1, 2020

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Provider Newsletter - Ohio Products & Programs Jun 1, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Provider News - Ohio Products & Programs Dec 1, 2019

Company to retire Blue Precision program at the end of the year

July 2021 Anthem Provider News - Ohio Products & Programs Jul 1, 2021

Reminder: Back Pain Guide program effective July 19, 2021

July 2021 Anthem Provider News - Ohio Products & Programs Jul 1, 2021

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Provider News - Ohio Products & Programs Nov 1, 2019

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020*

March 2020 Anthem Provider News - Ohio Products & Programs Mar 1, 2020

Some requests to AIM may require documentation to support prior authorization

August 2021 Anthem Provider News - Ohio Products & Programs Aug 1, 2021

Upcoming Changes for Automotive Accounts

December 2018 Anthem Ohio Provider Newsletter Products & Programs Dec 1, 2018

GM Precertification and Integrated Health Management (360 Health) changes for CY 2019

December 2018 Anthem Ohio Provider Newsletter Products & Programs Dec 1, 2018

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020*

September 2020 Anthem Provider News - Ohio Products & Programs Sep 1, 2020

Meet your Cancer Care Navigator

Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.
September 2020 Anthem Provider News - Ohio Products & Programs Sep 1, 2020

Predictive analytics guide proactive support to patients undergoing chemotherapy resulting in lowered admissions

September 2020 Anthem Provider News - Ohio Products & Programs Sep 1, 2020

UPDATE: new Rehabilitative Program now effective August 1, 2019

Anthem Ohio UPDATE: new Rehabilitative Program now effective August 1, 2019 Products & Programs Jul 3, 2019

New AIM Rehabilitative program effective July 1, 2019

April 2019 Anthem Provider Newsletter - Ohio Products & Programs Apr 1, 2019

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

October 2019 Anthem Provider News - Ohio Products & Programs Oct 1, 2019

UPDATE: New Rehabilitative Program remains temporarily delayed

Anthem Ohio UPDATE: New Rehabilitative Program remains temporarily delayed Products & Programs Jul 16, 2019

Pharmacy information available at anthem.com

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

Clinical Criteria coding updates for specialty pharmacy are available

July 2019 Anthem Provider News - Ohio Pharmacy Jul 1, 2019

Clinical criteria updates for specialty pharmacy

July 2019 Anthem Provider News - Ohio Pharmacy Jul 1, 2019

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

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

IngenioRx introduces new pharmacy network in 2021

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