California
Provider Communications

Articles Category: State & Federal / Cal MediConnect

Title Publication Category Date

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
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