California
Provider Communications

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management

Chronic disease management strategies for your patients with hypertension and diabetes
Date: Friday, October 8, 2021
Time: 12:00 p.m. ET

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

For 2022, Anthem Blue Cross continues to offer EPO and HMO Individual on and off exchange products, and is excited to announce the expansion of the EPO offerings to new regions

Your recommendation is key to encouraging cancer screenings for your female patients

Good news! Non-payment remittance advice enhancements coming soon

Looking to earn continuing medical education credits? Register for these on-demand webinars

Clinical appeals

Are you talking to ALL of your patients about breast cancer screenings?

African American and Hispanic women have higher risk of death from breast cancer than their White counterparts.¹

Network leasing arrangements

Provider education

Provider directory and provider data updates

Stay “in the know” at no charge!

REMINDER: EnrollSafe, the new electronic funds transfer enrollment portal for Anthem Blue Cross providers – replacing CAQH Enrollhub effective November 1, 2021

Reimbursement policy clarification: Claims Requiring Additional Documentation - facility

Pharmacy information available on anthem.com/ca

Diabetes testing and screening HEDIS measures

New policy: Sexually transmitted infections testing, effective January 1, 2022 - professional

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

Keep up with Medi-Cal news – October 2021

• 2021 affirmative statement concerning utilization management decisions

• May 2021 Medical Policies and Utilization Management Guidelines update

Information about 2021 special needs plans

New policy: Sexually transmitted infections testing, effective January 2022 - professional

HEDIS® medical record submission made easier with our remote EMR access service

New medical step therapy requirements

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

Keep up with Medicare news – October 2021

• May 2021 Medical Policies and Utilization Management Guidelines update

• 2021 affirmative statement concerning utilization management decisions

New policy: Sexually transmitted infections testing, effective January 2022 - professional

New specialty pharmacy medical step therapy requirements

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

Keep up with Cal MediConnect news October 2021

• May 2021 Medical Policies and Utilization Management Guidelines update

• 2021 affirmative statement concerning utilization management decisions

Register today for the Exploring the Impact of Racial Trauma on the Health and Wellbeing of Children forum on September 29, 2021

California wildfires: help for our members!

Important update: Help for members impacted by wildfires in California

National accounts 2022 pre-certification list

Your participation is required: Timely access regulations and language assistance program

Statin therapy for patients with diabetes

6 simple strategies to help increase medication adherence

HEDIS® medical record submission made easier with our remote EMR access service

Cure for the common cold: rest, fluids and this free prescription pad

Register now for our September CME webinars!

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

Introducing EnrollSafe, the new electronic funds transfer enrollment portal for Anthem Blue Cross providers – replacing CAQH Enrollhub effective November 1, 2021.

Benefit plan updates, effective January 1, 2022

Keep up with Medi-Cal news - September 2021

Reimbursement policy update: DRG inpatient facility transfers

Utilization management authorization rule operations

Prior authorization form notification

Keep up with Medicare news - September 2021

Prior authorization form notification

Keep up with Cal MediConnect news - September 2021

Action required: member grievance and appeals attestation

Anthem Blue Cross’ (Anthem) participating providers are REQUIRED to acknowledge (annually) that member grievance and appeals forms, a description of grievance procedures, and assistance in filing grievances are readily available at each contracted provider location(s).

Important update: Help for members impacted by wildfires in California

Member grievance and appeals attestation requirement

Participating providers are required to acknowledge (annually) that Member Grievance and Appeals forms, a description of grievance procedures, and assistance in filing grievances are readily available at each contracted provider location(s).

Telehealth visits can impact after-hospitalization follow-up care for mental illness

Reductions in missed appointments are significant.

Clearing up-coding confusion for retinal eye exams (DRE)

Register now for our August CME webinars!

Schedule appointments online through Availity

Specialty dose rounding program for certain oncology medications

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

Anthem Blue Cross to update formulary lists for commercial health plan pharmacy benefit, October 1, 2021

Immune globulin adjusted body weight dosing program beginning August 1, 2021

Pharmacy information available on anthem.com/ca

Reimbursement policy update: Claims requiring additional documentation (facility)

Preventing claims denials: Shingles vaccine

Know best: Shingles vaccinations are a Medicare Part D benefit whether administered in your office or in the pharmacy.

Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907

Infliximab Step Therapy – effective July 15, 2021

Help for members impacted by wildfires in California

Register for upcoming August CME webinars

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET

10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET

6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET

Register Now!

Clinical quality in practice: CME webinar series

Timely receipt of the primary payer’s EOB can help reduce timely filing denials for secondary claims

Proper coding for in-home monitoring can make a measurable difference for INR

Medical practices – are you keeping something from us

Another mark of the pandemic: An increase in childhood obesity

How to enroll in electronic fund transfer for faster remittance

Electronic claim response files

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

Overlapping service areas

Where and how to submit BlueCard claims

BlueCard® program quick tips

Practice status: open or closed

Certain specialty medication precertification requests may require additional documentation

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

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

Coding spotlight: Mental disorders in childhood

What matters most: Improving the patient experience

Resources to support your diverse patient panel

Infusion step therapy retraction notice

Specialty pharmacy prior authorization retraction notice

February 2021 medical policies and utilization management guidelines update

Prior authorization requirement changes effective September 1, 2021 – UM AROW 1327

Certain specialty medication precertification requests may require additional documentation

Let’s vaccinate

Prior authorization requirement changes effective October 1, 2021 – UM AROW 1837

March 2021 medical drug benefit clinical criteria updates

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

Let’s vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies

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

March 2021 Medical drug benefit clinical criteria updates

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

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

Let’s vaccinate