California
Provider Communications

Support documentation for AIM prior authorization requests

Regulatory HMO Contract Amendment – HMO Provider Agreement with Anthem Blue Cross

2022 Provider satisfaction survey

CAA: Keep your provider directory information up to date

Claims status message enhancements: Providing clear descriptions and actionable next steps

Authorization application enhancements: Faster, easier, and more efficient

Join our webcast on Wednesday, November 9, 2022, at 11 a.m. ET. Register here.

Submit digital attachments within seven-calendar days for claims filed with a PWK segment indicator

RETRACTION - You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too

Visit the Provider Learning Hub to view our latest learning opportunities

Remote EMR access service for HEDIS

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

Important information about utilization management

Alcohol use disorders often coexist with psychiatric disorders

Keep up with Medi-Cal news - November 2022

• Prior authorization requirement changes effective November 1, 2022
• Diabetes Prevention Program
• Medical drug benefit Clinical Criteria updates
• No Wrong Door policy

New Plan Announcement

Personalized Match

Keep up with Medicare news - November 2022

• Medical drug benefit Clinical Criteria updates
• Anthem Blue Cross expands specialty pharmacy precertification list
• New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
• New specialty pharmacy medical step therapy requirements (Zarxio)

Keep up with Cal MediConnect news - November 2022

• Anthem Blue Cross expands specialty pharmacy precertification list
• New specialty pharmacy medical step therapy requirement (Avastin, Mvasi)
• New specialty pharmacy medical step therapy requirement (Zarxio)
• Medical drug benefit Clinical Criteria updates

Register for our upcoming CME webinar about low back pain management

Action Required: 2022 Member Grievance and Appeals Attestation Requirement

Help for members impacted by wildfires

Monkeypox and smallpox vaccines: Product code on claims

CAA: Review your online provider directory information

The Provider Learning Hub is here

We want to hear from you – 2022 Provider Satisfaction Survey

National Accounts 2023 pre-certification list

Member benefit lookup by procedure code

IngenioRx will become CarelonRx on January 1, 2023

Pharmacy information available on provider website

Members’ Rights and Responsibilities section

Reimbursement Policy RETRACTION: Sexually transmitted infections testing – professional

Monkeypox resources and recommendations for our care providers

New specialty pharmacy medical step therapy requirements

Keep up with Medi-Cal news – October 2022

• Prior authorization updates for medications billed under the medical benefit for Tivdak, Saphnelo, Ryplazim

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

Courtesy notification of specialty pharmacy medical step therapy updates

Reimbursement Policy RETRACTION: Sexually transmitted infections testing – professional

Policy 21-001, effective 01/01/2022

Keep up with Medicare news – October 2022

• Medicare Part B Precert Expansion Alymsys
• Medicare Part B Precert Expansion Amvuttra Xipere
• Consultation Codes

Courtesy notification of specialty pharmacy medical step therapy updates

Reimbursement Policy RETRACTION: Sexually transmitted infections testing – professional

Keep up with Cal MediConnect news - October 2022

• Medicare Part B Precert Expansion Alymsys

• Medicare Part B Precert Expansion Amvuttra Xipere

Monkeypox resources and recommendations for our care providers

Continuing to Explore the Intersection of Race and Disability

Help for members impacted by wildfires in California

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

California Department of Managed Health Care All Plan Letter 22-017 on the coverage of COVID-19 therapeutics

California Department of Managed Health Care All Plan Letters mid-year 2022 and 2021

Continuing to Explore the Intersection of Race and Disability

Important information about women’s preventive care visits

Drug code billing reminder

Timely Access Regulations and Language Assistance program

Anthem Blue Cross to accept Hospital in Home services

New Back Pain Management program

Updates to the Claim Attachment workflow

Timely Access Regulations and Language Assistance program

Update to formulary lists for Commercial health plan pharmacy benefit

Alcohol use disorders linked to chronic diseases

Reimbursement policy update – Modifiers 25 and 57: Evaluation and Management with Global Procedures

Complex Case Management program

Enhancing claims attachment processes through digital applications

Prior authorization updates for medications billed under the medical benefit

New specialty pharmacy medical step therapy requirements

Keep up with Medi-Cal news – September 2022

• Clinical criteria update

• Access to care standards

Reimbursement policy update – Modifiers 25 and 57: Evaluation and Management with Global Procedures

Reminder: AIM Prior authorization phone number change for Medicare

Enhancing claims attachment processes through digital applications

Anthem Blue Cross Expands Specialty Pharmacy Precertification list

Keep up with Medicare news – September 2022

• Clinical Criteria Updates

• Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

• Anthem Blue Cross expands specialty pharmacy precertification list

Prior authorization requirement changes effective date December 1, 2022

Reimbursement policy update – Modifiers 25 and 57: Evaluation and Management with Global Procedures

Anthem Blue Cross Expands Specialty Pharmacy Precertification list

Keep up with Cal MediConnect news - September 2022

• Anthem Blue Cross expands specialty pharmacy precertification list

• Clinical Criteria Updates

Help for members impacted by wildfires in California

Update: Outpatient prepay itemized bill review program

Timely updates help keep our provider directories current

California Senate Bill 306 Sexually Transmitted Disease Testing

Reminder: Inpatient/outpatient commercial claim denials

Performance enhancements to the authorization application on Availity Essentials

Introducing the Provider Learning Hub

Add supporting documents directly to your claims with the new Claims Status Send Attachments feature

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

Pharmacy information available online

HEDIS 2022: Summary of changes from NCQA

Chlamydia screening

Using SBIRT to address opioid and substance use disorders

Updated quality performance requirements

The cost of alcohol use disorder

Prior authorization requirement changes updated effective date November 1, 2022

Join us for our next clinical quality in practice webinar

California Department of Managed Health Care All Plan Letter 22 017 on the coverage of COVID-19 therapeutics

Introducing Elevance Health: Focusing on whole health and its most powerful drivers

Please note that the important message below from Bryony Winn – President, Health Solutions – applies to our Commercial, Medicaid and Medicare Advantage programs from Anthem Blue Cross.

CAA: Keep your provider directory information current

Action required: 2022-member grievance and appeals attestation requirement

Anthem Blue Cross cost transparency

Provider transparency update

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

Clearing up coding confusion for diabetic retinal screenings

Help patients heal from the comfort of home with Hospital in Home care

Enhancing claims attachment processes through digital applications: Add attachments through Claims Status Inquiry

Coming soon: The Anthem Blue Cross Provider Learning Hub makes Availity learning easier