California
Provider Communications

April 2019 Anthem Blue Cross Provider Newsletter - California

Title	Category
Pharmacy information available on anthem.com/ca	Pharmacy
New look to Claim Status and Secure Messaging on the Availity Portal (for California)	Administrative
Now available Anthem Blue Cross’ new Digital Enrollment application	Administrative
Anthem Blue Cross Commercial Risk Adjustment (CRA) reporting update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided	Administrative
Workers’ Compensation Physicians Acknowledgments required by California Code of Regulations	Administrative
Contracted provider claim escalation process	Administrative
Provider Education seminars, webinars, workshops and more!	Administrative
Anthem Blue Cross provider directory and provider data updates	Administrative
Easily update provider demographics with the online Provider Maintenance Form	Administrative
Sign-up now for our Network eUPDATE today – it’s free!	Administrative
Network leasing arrangements	Administrative
Misrouted protected health information	Administrative
Clinical practice and preventive health guidelines available online	Policy Updates
Update: New prior authorization for Physical, Occupational and Speech Therapy Services will begin May 1, 2019	Medical Policy & Clinical Guidelines
Treatment guidelines for Medical Treatment Utilization Schedule update, effective April 18, 2019	Medical Policy & Clinical Guidelines
Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred	Medicare
Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members	Medicare
Medicare preferred PPO plan available to Laborers Health and Welfare Trust Fund for Northern California retirees	Medicare
Electronic claim payment reconsideration	Medicare
Keep up with Medicare news	Medicare
Reimbursement policy update, Modifier 22: Increased procedural service	Medi-Cal Managed Care
November 2018 Medical Policies and Clinical Utilization Management Guidelines update	Medi-Cal Managed Care
Practitioners’ rights during credentialing process	Medi-Cal Managed Care
Provider surveys	Medi-Cal Managed Care
Diabetes prevention program	Medi-Cal Managed Care
Tobacco cessation requirements for Medi-Cal Managed Care (Medi-Cal) providers	Medi-Cal Managed Care
Medical necessity review for appropriate level of care	Medi-Cal Managed Care
Appointment access standards	Medi-Cal Managed Care
Regulatory updates	Medi-Cal Managed Care
Clinical Criteria updates	Medi-Cal Managed Care
Nicotine replacement products	Medi-Cal Managed Care
Health education classes and Language assistance programs	Medi-Cal Managed Care

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California
Provider Communications

April 2019 Anthem Blue Cross Provider Newsletter - California

Pharmacy information available on anthem.com/ca

New look to Claim Status and Secure Messaging on the Availity Portal (for California)

Now available Anthem Blue Cross’ new Digital Enrollment application

Anthem Blue Cross Commercial Risk Adjustment (CRA) reporting update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

Workers’ Compensation Physicians Acknowledgments required by California Code of Regulations

Contracted provider claim escalation process

Provider Education seminars, webinars, workshops and more!

Anthem Blue Cross provider directory and provider data updates

Easily update provider demographics with the online Provider Maintenance Form

Sign-up now for our Network eUPDATE today – it’s free!

Network leasing arrangements

Misrouted protected health information

Clinical practice and preventive health guidelines available online

Update: New prior authorization for Physical, Occupational and Speech Therapy Services will begin May 1, 2019

Treatment guidelines for Medical Treatment Utilization Schedule update, effective April 18, 2019

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

Medicare preferred PPO plan available to Laborers Health and Welfare Trust Fund for Northern California retirees

Electronic claim payment reconsideration

Keep up with Medicare news

Reimbursement policy update, Modifier 22: Increased procedural service

November 2018 Medical Policies and Clinical Utilization Management Guidelines update

Practitioners’ rights during credentialing process

Provider surveys

Diabetes prevention program

Tobacco cessation requirements for Medi-Cal Managed Care (Medi-Cal) providers

Medical necessity review for appropriate level of care

Appointment access standards

Regulatory updates

Clinical Criteria updates

Nicotine replacement products

Health education classes and Language assistance programs

CaliforniaProvider Communications

April 2019 Anthem Blue Cross Provider Newsletter - California

California
Provider Communications