Ohio
Provider Communications

Articles

Title Publication Category Date

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (Updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Ohio Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Ohio Administrative May 29, 2020

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Ohio Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Ohio Administrative May 1, 2020

COVID-19 information repository for Anthem Care Providers

May 2020 Anthem Provider News - Ohio Administrative May 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 2020

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.
May 2020 Anthem Provider News - Ohio Administrative May 1, 2020

The 2020 Provider Manual is now available

May 2020 Anthem Provider News - Ohio Administrative May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - May 2020*

May 2020 Anthem Provider News - Ohio Pharmacy May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News - Ohio Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News - Ohio Administrative May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

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

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

Reminder about system updates

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

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Ohio Administrative Apr 10, 2020

Notice of Material Changes/Amendments to Contract and/or Prior Authorization Changes - April 2020

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.

April 2020 Anthem Provider News - Ohio Administrative Apr 1, 2020

Information from Anthem for Care Providers about COVID-19

* Please bookmark/add to favorites Provider News Home for the latest information about COVID-19.
April 2020 Anthem Provider News - Ohio Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition*

April 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Apr 1, 2020

Trusted Senior Care Advantage - a delegated provider for southeastern Ohio Medicare Advantage membership

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Greater Dayton Senior Care Advantage - a delegated provider for Dayton, OH Medicare Advantage membership

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Anthem continues focus on updates to our public provider website

April 2020 Anthem Provider News - Ohio Administrative Apr 1, 2020

Provider Transparency Update

April 2020 Anthem Provider News - Ohio Administrative Apr 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - April 2020*

April 2020 Anthem Provider News - Ohio Pharmacy Apr 1, 2020

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements*

April 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Apr 1, 2020

Anthem to delay most April 1, 2020 formulary list updates for commercial health plan pharmacy benefit

COVID-19 Information - Ohio Pharmacy Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical record request requirements

April 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Apr 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medicare News - April 2020

View these Medicare notices:
- Coding tip for psychological and neuropsychological testing
- Medical Policies and Clinical Utilization Management Guidelines update
- New Medicare Advantage opioid treatment Program benefit
- Prior authorization requirements: new 2020 codes for coverage and precertification
April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates - December 2019

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Updated COVID-19 Medicare Information

For the latest COVID-19 Medicare information, please check Medicare Advantage Provider News Archives.
COVID-19 Information - Ohio Medicare Mar 25, 2020

Anthem acquires Beacon Health Options

April 2020 Anthem Provider News - Ohio Administrative Mar 2, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - March 2020

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.
March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

Provider News site enhancements

March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

New Substance Use Resource Center available

March 2020 Anthem Provider News - Ohio Behavioral Health Mar 1, 2020

Anthem Commercial Risk Adjustment (CRA) Program Update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

Patient360 enhancement for medical providers

March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

Modifier use reminders

March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

Important coding reminder for walk-in retail health clinics

March 2020 Anthem Provider News - Ohio Administrative Mar 1, 2020

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

National Drug Code requirement on outpatient claims*

March 2020 Anthem Provider News - Ohio Pharmacy Mar 1, 2020

Pharmacy information available at anthem.com

March 2020 Anthem Provider News - Ohio Pharmacy Mar 1, 2020

Medicare News - March 2020

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Complex discharge planning

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Personal Home Helper benefit

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Reminder: Mid-level practitioners are required to file using their NPI

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Non-preferred products and corresponding preferred alternatives

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - February 2020

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.
February 2020 Anthem Provider News - Ohio Administrative Feb 1, 2020

Clinical Laboratory Improvements Amendments for Anthem*

February 2020 Anthem Provider News - Ohio Administrative Feb 1, 2020

Anthem SOAP Notes/Health Assessments for 2019 calendar year are due February 15, 2020

February 2020 Anthem Provider News - Ohio Administrative Feb 1, 2020

Shine Light on Depression

February 2020 Anthem Provider News - Ohio Behavioral Health Feb 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2020 Anthem Provider News - Ohio Pharmacy Feb 1, 2020

Medical Policy and Clinical Guideline Updates - February 2020*

February 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2020

Medicare News - February 2020

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

Reimbursement Policy Update: Modifier 62: Co-Surgeons

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- January 2020

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements (MAC) may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Medicare News -- January 2020

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Postponed -- Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Ohio IAM Local 2848 Retiree VEBA moves to Medicare Advantage plan under Anthem

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Postponed: Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Availity: Upcoming retirement planned for legacy Medical Attachment submission tool

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Let Us Help You Accomplish Your 2020 “To-Do List” Early - EDI Migration

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

The New Year brings New ID Cards for many Anthem members

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

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

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair*

January 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jan 1, 2020

Outpatient Facility Edit Implementation*

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

2020 FEP® Benefit information available online

January 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2020

Introducing ConcertoHealth

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Electric Boat offers Medicare Advantage options

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

2020 Medicare risk adjustment provider trainings

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Medicare preferred continuous glucose monitors

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

August 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

September 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Group Retiree Solutions Kentucky and Ohio HMO Medicare Advantage plans

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

State Auto Insurance Companies to offer Medicare Advantage option

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Anthem works to simplify payment recovery process for National Accounts membership

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Retrieve your Anthem Patient’s HEDIS® care gaps through Patient360 located on the Availity portal

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Case management program

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019
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