CommercialDecember 1, 2018
December 2018 Anthem Blue Cross Provider Newsletter - California
Administrative
CommercialDecember 1, 2018
Claims system updates for 2019: ProfessionalCommercialDecember 1, 2018
Coding tip: Claims processed with Modifier 79 should be reported by the same health care professionalCommercialDecember 1, 2018
Misrouted protected health informationCommercialDecember 1, 2018
Contracted provider claim escalation processCommercialDecember 1, 2018
Hospital recognition: NTSV C-Section RatesCommercialDecember 1, 2018
Availity to serve as EDI entry point for electronic submissionsCommercialDecember 1, 2018
Integrated Care Model for plans purchased on the health insurance marketplace benefits patients and physiciansCommercialDecember 1, 2018
Anthem Blue Cross works to simplify payment recovery process for National Accounts membershipCommercialDecember 1, 2018
Interactive Care ReviewerCommercialDecember 1, 2018
Individual on and off exchange plans: 2019 benefit year updateCommercialDecember 1, 2018
Workers’ Compensation Physicians Acknowledgments required by California Code of Regulations §9767.5.1 Medical Provider NetworksCommercialDecember 1, 2018
Provider Education seminars, webinars, workshops and more!CommercialDecember 1, 2018
Anthem Blue Cross provider directory and provider data updatesCommercialDecember 1, 2018
Easily update provider demographics with the online Provider Maintenance FormCommercialDecember 1, 2018
Sign-up now for our Network eUPDATE today – it’s free!CommercialDecember 1, 2018
Network leasing arrangementsPolicy Updates
CommercialDecember 1, 2018
Clinical practice and preventive health guidelines available onlineCommercialDecember 1, 2018
Members’ rights and responsibilitiesCommercialDecember 1, 2018
Vaginal birth after cesarean certified shared decision making aid available on the webCommercialDecember 1, 2018
An overview of our medical necessity review processCommercialDecember 1, 2018
HEDIS 2018: Commercial results are inCommercialDecember 1, 2018
Restructure of AIM advanced imaging clinical appropriateness guidelinesCommercialDecember 1, 2018
Update to AIM clinical appropriateness guidelinesCommercialDecember 1, 2018
Anthem works to help ensure appropriate billing of E&M servicesCommercialDecember 1, 2018
Important reminder: Professional reimbursement policy update Scope of LicenseProducts & Programs
CommercialDecember 1, 2018
Case management programCommercialDecember 1, 2018
Coordination of careCommercialDecember 1, 2018
ConditionCare program benefits patients and physiciansCommercialDecember 1, 2018
Timely access regulations and language assistance programCommercialDecember 1, 2018
Coordination of benefits for an Federal Employee Plan memberCommercialDecember 1, 2018
Benefit change for Infliximab for Federal Employee ProgramCommercialDecember 1, 2018
2019 FEP Benefit information available onlineCommercialDecember 1, 2018
Introducing the new Clinical Criteria page for injectable, infused or implanted drugsCommercialDecember 1, 2018
Pharmacy information available on anthem.com/caCommercialDecember 1, 2018
Anthem Blue Cross accepts electronic prior authorization requests for prescription medications onlineState & Federal
Medicare AdvantageDecember 1, 2018
Keep up with Medicare newsMedicare AdvantageDecember 1, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019Medicare AdvantageDecember 1, 2018
2019 Medicare Advantage individual benefits and formulariesMedicare AdvantageDecember 1, 2018
CMS Medicare Preclusion list effective April 1, 2019Medicare AdvantageDecember 1, 2018
When and how to initiate Medicare Advantage reopeningsMedicare AdvantageDecember 1, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019Medicare AdvantageDecember 1, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019Medicare AdvantageDecember 1, 2018
Los Angeles Unified School District offers Medicare Advantage optionMedicaidDecember 1, 2018
Quarterly pharmacy formulary changeMedicaidDecember 1, 2018
Claims requiring additional documentationMedicaidDecember 1, 2018
Coding spotlight: Substance use disorders and smokingMedicaidDecember 1, 2018
Prior authorization requirements for subcutaneous implantable defibrillator systemMedicaidDecember 1, 2018
Need up to date pharmacy information?MedicaidDecember 1, 2018
Practitioners’ rights during credentialing processMedicaidDecember 1, 2018
Updated prior authorization form for providersMedicaidDecember 1, 2018
Electronic data interchange gateway updateMMP (Medicare-Medicaid Plan)December 1, 2018
Claims requiring additional documentationMMP (Medicare-Medicaid Plan)December 1, 2018
Short and long acting narcotics regulatory changes and limits to days’ suppliesMMP (Medicare-Medicaid Plan)December 1, 2018
Prior authorization requirements for Part B drug NivestymMMP (Medicare-Medicaid Plan)December 1, 2018
Electronic data interchange gateway updateMMP (Medicare-Medicaid Plan)December 1, 2018
MediConnect Plan network updateTo view this publication online:
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