California
Provider Communications

Professional system updates for 2023

Outpatient system updates for 2023

Engagement with your patient counts

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

Childhood Immunization Status and Lead Screening in Children for HEDIS

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

Monkeypox and smallpox vaccines: Product code on claims

Engagement with your patient counts

Keep up with Medi-Cal news - January 2023

• Population Needs Assessment report
• Remind your patients to update their Medi-Cal Managed Care information

New plan announcement

Engagement with your patient counts

Keep up with Medicare news - January 2023

• Prior authorization requirement changes
• New specialty pharmacy medical step therapy requirements
• Anthem Blue Cross expands specialty pharmacy precertification list

Keep up with Cal MediConnect news - January 2023

• Prior authorization requirement changes
• New specialty pharmacy medical step therapy requirements
• Anthem Blue Cross expands specialty pharmacy precertification list

An overview of our medical necessity review process

Senate Bill 245 addressing abortion, abortion related services, cost sharing and utilization management, including prior authorizations

CAA: Timely updates help keep our provider directories current

Clinical practice and preventive health guidelines available on anthem.com/ca

Members’ rights and responsibilities

Member’s assessment of behavioral healthcare after-hours messaging in 2022

Coordination of care

Case management program

Contract compliance with accessibility standards for Appointment Availability and Emergency Care instructions after hours care

IngenioRx will become CarelonRx on January 1, 2023

Signature requirements for laboratory orders or requisitions

Reminder - updated AIM Musculoskeletal program effective January 1, 2023 - site of care reviews

Reimbursement policy retraction: updates to professional and facility reimbursement policies

Reimbursement policy update: Multiple Surgery - Facility

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

Overlapping Blue Plan service areas

BlueCard program quick tips

Find answers to BlueCard questions

Practice status: open or closed

Does your practice offer telehealth services? Let us know!

Pharmacy information available on the provider website

Update to the Pregnancy Notification Form

New Digital Provider Enrollment tool added to Availity

Keep up with Medi-Cal news - December 2022

• Medical Policies and Clinical Utilization Management Guidelines update
• Prior authorization updates for medications billed under the medical benefit (Releuko, Vabysmo)

2023 Medicare Advantage service area and benefit updates

Personal home helper benefit ending

Keep up with Medicare news - December 2022

• AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update
• Medical Policies and Clinical Utilization Management Guidelines update

Cal MediConnect Plans change effective January 1, 2023

Keep up with Cal MediConnect news - December 2022

• Medical Policies and Clinical Utilization Management Guidelines update
• Medical drug benefit Clinical Criteria updates