California
Provider Communications

August 2018 Anthem Blue Cross Provider Newsletter - California

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Title Category

Additional support available for members with rare conditions

Medical Policy & Clinical Guidelines

Anthem Blue Cross accepts prior authorization requests for prescription medications online

Pharmacy

Anthem Blue Cross adopts 22nd edition of the MCG care guidelines

Medi-Cal Managed Care

Anthem Blue Cross provider directory and provider data updates

Administrative

Anthem Blue Cross to enhance automated claim edits for professional claims

Administrative

Anthem Blue Cross to update drug lists supporting commercial health plans

Pharmacy

Anthem Blue Cross’ new Musculoskeletal Program to implement August 15, 2018

Medical Policy & Clinical Guidelines

Availity partners with Anthem Blue Cross as their designated EDI Gateway

Administrative

CA Workers’ Compensation formulary in effect

Drug formulary transition for injured workers
Pharmacy

Check out the enhancements to the Interactive Care Reviewer tool!

Administrative

Clinical practice and preventive health guidelines available online

Medical Policy & Clinical Guidelines

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

Medicare

Coding spotlight: Obesity

Medi-Cal Managed Care

Contracted provider claim escalation process

Administrative

Daily morphine equivalent dosing limit

Pharmacy

Delay in launch of prior authorization for Lutathera until November 1, 2018

Medical Policy & Clinical Guidelines

DME providers and physicians: important wheelchair prior authorization information

Medicare

Easily update provider demographics with the online Provider Maintenance Form

Administrative

Electronic data interchange migration to Availity

Medi-Cal Managed Care

Electronic data interchange migration to Availity

Cal MediConnect

Health Care Reform Updates (including Health Insurance Exchange)

Important information available online
Administrative

Important changes to Anthem Blue Cross’ specialty pharmacy clinical site of care

Pharmacy

Important information about billing colonoscopy and related anesthesia services

Administrative

Important information about utilization management

Medi-Cal Managed Care

Keep up with Medicare news

Medicare

MA members receive incentives for completing screenings

Medicare

Mailing address for Federal Employee Program: Paper claims and claims related correspondence

Federal Employee Plan (FEP)

Member explanation of benefits gets a makeover

Administrative

Member rights and responsibilities statement

Medi-Cal Managed Care

MyDiversePatients.com

A website to support your diverse patients
Administrative

Network leasing arrangements

Administrative

New newsletter format launched today!

Administrative

Pharmacy information available on anthem.com/ca

Pharmacy

Prior authorization requirement for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

Medi-Cal Managed Care

Prior authorization requirements for Azedra (iobenguane l 131) and Poteligeo (mogamulizumab)

Cal MediConnect

Prior authorization requirements for Cabazitaxel (Jevtana

Medi-Cal Managed Care

Provider Education seminars, webinars, workshops and more!

Administrative

Provider transparency update

Administrative

Regulatory updates

Medi-Cal Managed Care

Reimbursement policy update; Medical recalls, policy 06-111 – effective November 1, 2018

Medi-Cal Managed Care

Reimbursement policy update; Medical recalls, policy 06-111 – effective November 1, 2018

Cal MediConnect

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

Administrative

Submit PA medication requests electronically; new phone number for MA prescription PAs

Medicare

The Anthem Workers’ Compensation Digital Marketplace is the new PPO!

This is a must read for physical therapists and MRI/Radiology providers
Administrative

Vaginal birth after cesarean (VBAC) aid available on the web

Medical Policy & Clinical Guidelines

Webinar for Availity EDI Gateway services

Administrative

Workers’ Compensation Physician Acknowledgments Required by California Code of Regulations

Administrative
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