California
Provider Communications

December 2018 Anthem Blue Cross Provider Newsletter - California

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Title	Category
Timely access regulations and language assistance program	Products & Programs
Case management program	Products & Programs
Coordination of care	Products & Programs
ConditionCare program benefits patients and physicians	Products & Programs
Introducing the new Clinical Criteria page for injectable, infused or implanted drugs	Pharmacy
Pharmacy information available on anthem.com/ca	Pharmacy
Hospital recognition: NTSV C-Section Rates	Administrative
Availity to serve as EDI entry point for electronic submissions	Administrative
Integrated Care Model for plans purchased on the health insurance marketplace benefits patients and physicians	Administrative
Anthem Blue Cross accepts electronic prior authorization requests for prescription medications online	Pharmacy
Anthem Blue Cross works to simplify payment recovery process for National Accounts membership	Administrative
Interactive Care Reviewer	Administrative
Individual on and off exchange plans: 2019 benefit year update	Administrative
Workers’ Compensation Physicians Acknowledgments required by California Code of Regulations §9767.5.1 Medical Provider Networks	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
Clinical practice and preventive health guidelines available online	Policy Updates
Members’ rights and responsibilities	Policy Updates
Vaginal birth after cesarean certified shared decision making aid available on the web	Policy Updates
An overview of our medical necessity review process	Policy Updates
HEDIS 2018: Commercial results are in	Policy Updates
Restructure of AIM advanced imaging clinical appropriateness guidelines	Medical Policy & Clinical Guidelines
Update to AIM clinical appropriateness guidelines	Medical Policy & Clinical Guidelines
Important reminder: Professional reimbursement policy update Scope of License	Reimbursement Policies
Misrouted protected health information	Administrative
Anthem works to help ensure appropriate billing of E&M services	Reimbursement Policies
Claims system updates for 2019: Professional	Administrative
Coding tip: Claims processed with Modifier 79 should be reported by the same health care professional	Administrative
Coordination of benefits for an Federal Employee Plan member	Federal Employee Plan (FEP)
Benefit change for Infliximab for Federal Employee Program	Federal Employee Plan (FEP)
2019 FEP Benefit information available online	Federal Employee Plan (FEP)
New Medicare Advantage provider service phone number beginning January 1, 2019	Medicare
2019 Medicare Advantage individual benefits and formularies	Medicare
CMS Medicare Preclusion list effective April 1, 2019	Medicare
When and how to initiate Medicare Advantage reopenings	Medicare
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019	Medicare
Medicare Part B drugs may include Step Therapy beginning January 1, 2019	Medicare
Los Angeles Unified School District offers Medicare Advantage option	Medicare
Keep up with Medicare news	Medicare
Quarterly pharmacy formulary change	Medi-Cal Managed Care
Claims requiring additional documentation	Medi-Cal Managed Care
Coding spotlight: Substance use disorders and smoking	Medi-Cal Managed Care
Prior authorization requirements for subcutaneous implantable defibrillator system	Medi-Cal Managed Care
Need up to date pharmacy information?	Medi-Cal Managed Care
Practitioners’ rights during credentialing process	Medi-Cal Managed Care
Updated prior authorization form for providers	Medi-Cal Managed Care
Electronic data interchange gateway update	Medi-Cal Managed Care
Claims requiring additional documentation	Cal MediConnect
Short and long acting narcotics regulatory changes and limits to days’ supplies	Cal MediConnect
Prior authorization requirements for Part B drug Nivestym	Cal MediConnect
Electronic data interchange gateway update	Cal MediConnect
MediConnect Plan network update	Cal MediConnect

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