California
Provider Communications

Articles Category: State & Federal / Cal MediConnect

Title	Publication	Category	Date
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

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