California
Provider Communications

Articles Category: State & Federal / Cal MediConnect

Title	Publication	Category	Date
Prior authorization form notification	September 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2021
Keep up with Cal MediConnect news - September 2021 MMP clinical criteria updates notification May 2021	September 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2021
New reimbursement policy – Modifier 90: Reference (outside) laboratory and pass-through billing	July 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2021
Let’s vaccinate Help increase your vaccination rates and close gaps-in-care with these tools and strategies	July 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2021
March 2021 Medical drug benefit clinical criteria updates	July 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2021
Attention facilities: Sending admission, discharge and transfer data to Anthem Blue Cross results in improved care management for patients	July 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2021
Medical drug benefit clinical criteria updates	June 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2021
Medical policies and clinical utilization management guidelines update	June 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2021
CG care guidelines 25th edition	June 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2021
Helping our members	May 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	May 1, 2021
Clinical criteria updates notification November 2020	April 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2021
Oncology dose reduction program beginning July 1, 2021	April 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2021
Clinical criteria updates notification December 2020	April 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2021
MCG Care Guidelines 24th edition customization	March 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Mar 1, 2021
Medical policies and clinical utilization management guidelines update	March 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Mar 1, 2021
Access to more claim denial information is now self-service	March 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Mar 1, 2021
Medical drug benefit Clinical Criteria updates – August 2020	February 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Feb 1, 2021
Medical drug benefit Clinical Criteria updates	February 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Feb 1, 2021
CORRECTION: Transition to AIM Small Joint guidelines is effective February 4, 2021	January 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2021
August 2020 MMP Medical Policies and Utilization Management Guidelines update	January 2021 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2021
Transition to AIM Specialty Health Rehabilitative Services Clinical Appropriateness Guidelines	December 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2020
Transition to AIM Small Joint guidelines	December 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2020
Medical drug benefit Clinical Criteria updates	November 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2020
Reimbursement Policy update: Nurse practitioner and physician assistant services, professional Reimbursement Policy (effective 04/24/20)	November 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2020
Digital transactions cut administrative tasks in half	November 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2020
Medical drug benefit Clinical Criteria updates	October 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Oct 1, 2020
Transition to AIM Specialty Health rehabilitative services clinical appropriateness guidelines	September 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2020
Medical drug benefit Clinical Criteria updates	August 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2020
Submit behavioral health authorizations via our online Interactive Care Reviewer tool	August 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2020
New MCG Care Guidelines 24th edition	August 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2020
Updates to AIM musculoskeletal program clinical appropriateness guidelines	August 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2020
Medical policies and clinical utilization management guidelines update	July 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2020
Medical drug benefit clinical criteria updates	July 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2020
Modifier use reminders	July 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2020
MCG care guidelines: 24th Edition	June 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2020
Anthem Blue Cross (Anthem) working with Optum to collect medical records for risk adjustment	June 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2020
Modifier use reminders	June 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2020
Updates to AIM Sleep Disorder Management clinical appropriateness guideline	June 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jun 1, 2020
Reimbursement policy update: Unlisted, unspecified or miscellaneous codes Policy 06-004, effective 08/01/20	May 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	May 1, 2020
Prior authorization requirements: new 2020 codes for coverage and precertification	April 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2020
Medical drug benefit clinical criteria updates for November 2019	April 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2020
Medical drug benefit clinical criteria updates for December 2019	April 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2020
Medical policies and clinical utilization management guidelines update	April 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Apr 1, 2020
Reminder: Mid-level practitioners are required to file using their NPI	March 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Mar 1, 2020
Professional and Facility Reimbursement Policy Update: Multiple and Bilateral Surgery	February 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Feb 1, 2020
Reimbursement Policy Update: Split-Care Surgical Modifiers, effective May 1, 2020	February 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Feb 1, 2020
Reminder to Anthem Blue Cross Cal MediConnect plan (Medicare-Medicaid Plan) providers	January 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2020
Pharmacy benefit manager changes to IngenioRx	January 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2020
Help protect your patients by providing medical ID protection – best practices	January 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2020
Medical drug benefit Clinical Criteria updates	January 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2020
Medical Policies and Clinical Utilization Management Guidelines update	January 2020 Anthem Blue Cross Provider News - California	Cal MediConnect	Jan 1, 2020
MMP CMS reminder: expedited/urgent requests	December 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2019
Global 3M19 Medical Policy and Technology Assessment Committee prior authorization requirement updates	December 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2019
Prior authorization requirements for E0784, K0553 and K0554	December 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2019
MMP Global 3M19 Medical Policy and Technology Assessment Committee prior authorization requirement updates	December 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Dec 1, 2019
Electronic submission is preferred method for requesting pharmacy prior authorization	November 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2019
Medical drug clinical criteria updates – Quarter 2	November 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2019
MMP clinical criteria updates	November 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2019
Medical drug clinical criteria updates – Quarter 1	November 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2019
MMP reimbursement new policy: Update drug screen testing	November 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Nov 1, 2019
MCG Care guidelines update and customizations	October 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Oct 1, 2019
June 2019 medical policies and clinical utilization management guidelines update	October 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Oct 1, 2019
Coming soon: electronic attachments	October 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Oct 1, 2019
Reimbursement policy update, Modifier 62: Co-Surgeons (Policy 06-010, effective 01/01/2020)	September 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2019
Pharmacy benefit manager change to IngenioRx	September 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2019
Changes to prior authorization requirements	September 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Sep 1, 2019
New service types added to Availity	August 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2019
Prepayment clinical validation review process	August 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2019
Unspecified diagnosis code update	August 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2019
New reimbursement policy: drug screen testing	August 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Aug 1, 2019
Home health billing guidelines for contracted providers	July 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2019
Sepsis diagnosis coding and billing reminder	July 2019 Anthem Blue Cross Provider News - California	Cal MediConnect	Jul 1, 2019
2019 Utilization management affirmative statement concerning utilization management decisions	June 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Jun 1, 2019
Reimbursement policy update: Professional anesthesia services Policy 06-019, effective 09/01/2019	June 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Jun 1, 2019
Partial hospitalization services	June 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Jun 1, 2019
Submitting corrected claims	June 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Jun 1, 2019
Medical records request for risk adjustment	May 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	May 1, 2019
Update: Evaluation and management with Modifier 25	May 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	May 1, 2019
MMP Prior authorization requirements for DME repair and portable oxygen concentrator	May 2019 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	May 1, 2019
Claims requiring additional documentation	December 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Dec 1, 2018
Short and long acting narcotics regulatory changes and limits to days’ supplies	December 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Dec 1, 2018
Prior authorization requirements for Part B drug Nivestym	December 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Dec 1, 2018
Electronic data interchange gateway update	December 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Dec 1, 2018
MediConnect Plan network update	December 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Dec 1, 2018
Prior authorization requirements for Part B drugs: Retacrit (epoetin alfa-epbx), Damoctocog and llumya (tildrakizumab)	October 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Oct 1, 2018
Short and long acting narcotics regulatory changes and limits to days’ supplies	October 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Oct 1, 2018
Prior authorization requirments for Part B drugs: Moxetumomab Pasudotox, Cemiplimab and Fulphila (pegfilgrastim-jmbd)	October 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Oct 1, 2018
Prior authorization requirements for Azedra (iobenguane l 131) and Poteligeo (mogamulizumab)	August 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Aug 16, 2018
Electronic data interchange migration to Availity	August 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Aug 16, 2018
Reimbursement policy update; Medical recalls, policy 06-111 – effective November 1, 2018	August 2018 Anthem Blue Cross Provider Newsletter - California	Cal MediConnect	Aug 16, 2018

Page 1 of 1

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use.