California
Provider Communications

June 2021 Anthem Blue Cross Provider News - California

Title	Category
Anthem Blue Cross to enhance claim edits for outpatient facility claims	Reimbursement Policies
Let’s Vaccinate Help increase your vaccination rates and close gaps-in-care with these tools and strategies.	Products & Programs
Pharmacy information available on anthem.com/ca	Pharmacy
Policy reminder: Inpatient readmissions	Medicare
Updates to the AIM advanced imaging clinical appropriateness guidelines	Medicare
Anthem Blue Cross working with Optum to collect medical records for risk adjustment	Medicare
Medical drug benefit clinical criteria updates	Medicare
Medical policies and clinical utilization management guidelines update	Medicare
Reminders for Medicare Advantage group retiree PPO plans and national access plus FAQ	Medicare
Provider education program survey: Your voice counts	Medi-Cal Managed Care
MCG care guidelines 25th edition	Medi-Cal Managed Care
Prior authorization updates for specialty pharmacy	Medi-Cal Managed Care
Keeping up with routine vaccination during COVID-19	Medi-Cal Managed Care
Aspire Health for members in need of palliative care	Medi-Cal Managed Care
Member grievance and appeals process	Medi-Cal Managed Care
Complex case management program	Medi-Cal Managed Care
Important information about utilization management	Medi-Cal Managed Care
Members’ rights and responsibilities statement	Medi-Cal Managed Care
DEXA bone scan criteria for the Federal Employee Program	Federal Employee Plan (FEP)
Two great learning resources on one secure portal	Digital Tools
Digital solution options with Availity	Digital Tools
Interactive Care Reviewer’s new copy feature decreases time to submit authorization request	Digital Tools
Essential information you need to submit EDI corrected claims	Digital Tools
Medical drug benefit clinical criteria updates	Cal MediConnect
Medical policies and clinical utilization management guidelines update	Cal MediConnect
CG care guidelines 25th edition	Cal MediConnect
Regular check-ins with your clearinghouse could affect timely filing	Administrative
Don’t miss this: Timely access regulations and language assistance program	Administrative
Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds	Administrative
Anthem Blue Cross provider directory and provider data updates	Administrative
Keep your contact information current	Administrative
Provider education	Administrative
Network leasing arrangements	Administrative

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California
Provider Communications

June 2021 Anthem Blue Cross Provider News - California

Anthem Blue Cross to enhance claim edits for outpatient facility claims

Let’s Vaccinate

Pharmacy information available on anthem.com/ca

Policy reminder: Inpatient readmissions

Updates to the AIM advanced imaging clinical appropriateness guidelines

Anthem Blue Cross working with Optum to collect medical records for risk adjustment

Medical drug benefit clinical criteria updates

Medical policies and clinical utilization management guidelines update

Reminders for Medicare Advantage group retiree PPO plans and national access plus FAQ

Provider education program survey: Your voice counts

MCG care guidelines 25th edition

Prior authorization updates for specialty pharmacy

Keeping up with routine vaccination during COVID-19

Aspire Health for members in need of palliative care

Member grievance and appeals process

Complex case management program

Important information about utilization management

Members’ rights and responsibilities statement

DEXA bone scan criteria for the Federal Employee Program

Two great learning resources on one secure portal

Digital solution options with Availity

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Essential information you need to submit EDI corrected claims

Medical drug benefit clinical criteria updates

Medical policies and clinical utilization management guidelines update

CG care guidelines 25th edition

Regular check-ins with your clearinghouse could affect timely filing

Don’t miss this: Timely access regulations and language assistance program

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

Anthem Blue Cross provider directory and provider data updates

Keep your contact information current

Provider education

Network leasing arrangements

CaliforniaProvider Communications

June 2021 Anthem Blue Cross Provider News - California

California
Provider Communications