CommercialDecember 1, 2018

December 2018 Anthem Blue Cross Provider Newsletter - California

Administrative

AdministrativeCommercialDecember 1, 2018

Claims system updates for 2019: Professional

AdministrativeCommercialDecember 1, 2018

Misrouted protected health information

AdministrativeCommercialDecember 1, 2018

Contracted provider claim escalation process

AdministrativeCommercialDecember 1, 2018

Hospital recognition: NTSV C-Section Rates

AdministrativeCommercialDecember 1, 2018

Availity to serve as EDI entry point for electronic submissions

AdministrativeCommercialDecember 1, 2018

Interactive Care Reviewer

AdministrativeCommercialDecember 1, 2018

Individual on and off exchange plans: 2019 benefit year update

AdministrativeCommercialDecember 1, 2018

Provider Education seminars, webinars, workshops and more!

AdministrativeCommercialDecember 1, 2018

Anthem Blue Cross provider directory and provider data updates

AdministrativeCommercialDecember 1, 2018

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

AdministrativeCommercialDecember 1, 2018

Network leasing arrangements

Policy Updates

Policy UpdatesCommercialDecember 1, 2018

Clinical practice and preventive health guidelines available online

Policy UpdatesCommercialDecember 1, 2018

Members’ rights and responsibilities

Policy UpdatesCommercialDecember 1, 2018

An overview of our medical necessity review process

Policy UpdatesCommercialDecember 1, 2018

HEDIS 2018: Commercial results are in

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2018

Restructure of AIM advanced imaging clinical appropriateness guidelines

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2018

Update to AIM clinical appropriateness guidelines

Reimbursement PoliciesCommercialDecember 1, 2018

Anthem works to help ensure appropriate billing of E&M services

Reimbursement PoliciesCommercialDecember 1, 2018

Important reminder: Professional reimbursement policy update Scope of License

Products & Programs

Products & ProgramsCommercialDecember 1, 2018

Case management program

Products & ProgramsCommercialDecember 1, 2018

Coordination of care

Products & ProgramsCommercialDecember 1, 2018

ConditionCare program benefits patients and physicians

Products & ProgramsCommercialDecember 1, 2018

Timely access regulations and language assistance program

Federal Employee Program (FEP)CommercialDecember 1, 2018

Coordination of benefits for an Federal Employee Plan member

Federal Employee Program (FEP)CommercialDecember 1, 2018

Benefit change for Infliximab for Federal Employee Program

Federal Employee Program (FEP)CommercialDecember 1, 2018

2019 FEP Benefit information available online

State & Federal

State & FederalMedicare AdvantageDecember 1, 2018

Keep up with Medicare news

State & FederalMedicare AdvantageDecember 1, 2018

New Medicare Advantage provider service phone number beginning January 1, 2019

State & FederalMedicare AdvantageDecember 1, 2018

2019 Medicare Advantage individual benefits and formularies

State & FederalMedicare AdvantageDecember 1, 2018

CMS Medicare Preclusion list effective April 1, 2019

State & FederalMedicare AdvantageDecember 1, 2018

When and how to initiate Medicare Advantage reopenings

State & FederalMedicare AdvantageDecember 1, 2018

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

State & FederalMedicare AdvantageDecember 1, 2018

Los Angeles Unified School District offers Medicare Advantage option

State & FederalMedicaidDecember 1, 2018

Quarterly pharmacy formulary change

State & FederalMedicaidDecember 1, 2018

Claims requiring additional documentation

State & FederalMedicaidDecember 1, 2018

Coding spotlight: Substance use disorders and smoking

State & FederalMedicaidDecember 1, 2018

Need up to date pharmacy information?

State & FederalMedicaidDecember 1, 2018

Practitioners’ rights during credentialing process

State & FederalMedicaidDecember 1, 2018

Updated prior authorization form for providers

State & FederalMedicaidDecember 1, 2018

Electronic data interchange gateway update

State & FederalMMP (Medicare-Medicaid Plan)December 1, 2018

Claims requiring additional documentation

State & FederalMMP (Medicare-Medicaid Plan)December 1, 2018

Short and long acting narcotics regulatory changes and limits to days’ supplies

State & FederalMMP (Medicare-Medicaid Plan)December 1, 2018

Prior authorization requirements for Part B drug Nivestym

State & FederalMMP (Medicare-Medicaid Plan)December 1, 2018

Electronic data interchange gateway update

State & FederalMMP (Medicare-Medicaid Plan)December 1, 2018

MediConnect Plan network update