California
Provider Communications

Anthem Blue Cross’ High-Performance network: Added Santa Clara Unified School District

May is National High Blood Pressure Education Month: We’ve got this!

Alcohol use disorder has a big cost

Expedited grievances

Screening for alcohol use disorder in high-prevalence demographics

Keep up with Medi-Cal news – May 2022

• Prior authorization requirement change for HCPCS code K1022
• Provider notification process
• New specialty pharmacy medical step therapy requirements

Convenient, reliable at-home testing for colorectal cancer and diabetes care

New Strategic Provider System implementation May 2022

HEDIS 2022: Summary of changes from NCQA

New specialty pharmacy medical step therapy requirements

Southern California Drug Benefit Fund moves to the Anthem Blue Cross Medicare Advantage plan

Keep up with Medicare news – May 2022

• Anthem Blue Cross expands specialty pharmacy precertification list
• Anthem Blue Cross expands specialty pharmacy precertification list
• New specialty pharmacy medical step therapy requirements

New specialty pharmacy medical step therapy requirements

Keep up with Cal MediConnect news - May 2022

• Anthem Blue Cross expands specialty pharmacy precertification list
• New specialty pharmacy medical step therapy requirements
• Anthem Blue Cross expands specialty pharmacy precertification list

Improving antibiotic use for acute respiratory infections in the outpatient setting

The Anthem, Inc. name is changing

CAA: Update your provider directory information

Catching up on routine vaccines

HEDIS 2022: Summary of changes from NCQA

Pharmacy information available on anthem.com/ca

Reminder on Botox® for Anthem Blue Cross members

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO Providers

The Anthem, Inc. name is changing

Reimbursement policy update: Inpatient Readmissions

Disease management/population health program

FDA warns about dental problems with buprenorphine medicines

Clinical criteria updates

Postpartum coverage expansion

Keep up with Medi-Cal news – April 2022

• Prior authorization required for specialty pharmacy drugs
• New specialty pharmacy medical step therapy requirements
• Medical drug benefit Clinical Criteria updates
• Medical Policies and Clinical Utilization Management guidelines update
• Quick tips to filing a complete and correct professional claim

The Anthem, Inc. name is changing

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

Reimbursement policy update: Inpatient Readmissions

Policy G-13001, effective 07/01/22

Model of Care required training

The impact of listening

Clinical criteria updates

Keep up with Medicare news – April 2022

• Quick tips to filing a complete and correct professional claim
• Medical Policies and Clinical Utilization Management Guidelines update
• AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
• Anthem Blue Cross expands specialty pharmacy precertification list

The Anthem, Inc. name is changing

Reimbursement policy update: Inpatient Readmissions

Policy G-13001, effective 07/01/22

Clinical criteria updates

Keep up with Cal MediConnect news - April 2022

• Medical Policies and Clinical Utilization Management Guidelines update
• Quick tips to filing a complete and correct professional claim
• Anthem Blue Cross expands specialty pharmacy precertification list
• Medical drug benefit Clinical Criteria updates

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

The Anthem, Inc. name is changing

Exploring Implicit Bias in Healthcare for Historically Marginalized Communities

Register today for the Exploring Implicit Bias in Healthcare for Historically Marginalized Communities forum hosted by Anthem Blue Cross and Motivo* for Anthem Blue Cross providers on March 16, 2022.

CAA: Have you reviewed your online provider directory information lately?

New! Vaccination resource page for providers

Coastal Foundation no longer provides claims and customer service for SISC

Simplifying requests for additional information

Your influence matters: Recommending cancer screenings to your patients

Understanding your patients’ differences is lifesaving

Timely access regulations and language assistance program

Enhancements to the Availity Authorization application are now available

Updated preventive care guidance regarding screening colonoscopies

Benefit change for CalPERS PPO Members: Important updates on certain medications‐ bevacizumab (Avastin), epoetin alfa (Epogen and Procrit), filgrastim (Neupogen), pegfilgrastim (Neulasta), rituximab (Rituxan), and trastuzumab (Herceptin)

Change to the Federal Employee Program® Clinical Grievance and Appeal address

HEDIS 2022 Federal Employee Program® medical record request requirements

It is CAHPs survey time!

Clinical utilization management guidelines update

Urinary tract infection toolkits are on the way

Keep up with Medi-Cal news – March 2022

• Prior authorization requirement changes — 97535 Self-care/home management training

Annual wellness visits for Medicare Advantage members

Pharmacy updates

Clinical criteria updates

Teamsters Retiree Trust offers Medicare Advantage option

Provider notification for utilization management authorization rule operations workgroup item 2662

New Strategic Provider System will launch in April 2022

Keep up with Medicare news – March 2022

• Medical step therapy updates

• Phone number change for AIM in California

Keep up with Cal MediConnect news - March 2022

• Medical step therapy updates

Payment for COVID-19 testing services and vaccine administration on or after January 1, 2022

Prepare for the CAA: Keep your provider directory information current

Heart disease is the number one killer of women

Share information with patients about taking an active role in their heart health.

For 2022, Anthem continues to offer EPO and HMO individual on and off exchange products, and we are excited to announce our expansion of the EPO offerings to new regions

Cancer care navigator

It is CAHPS survey time!

Pharmacy information available on anthem.com/ca

Get faster payments with EFT

Keep up with Medi-Cal news – February 2022

Get faster payments with EFT

Keep up with Medicare news – February 2022

Get faster payments with EFT

Information from Anthem for Care Providers About COVID-19 – RETIRED as of November 8, 2022

As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Future updates regarding COVID-19 will appear in the monthly Provider News publication.

New Medicare Advantage plan will have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing Providers Nationally

Effective April 1, 2022, approximately 200,000 Medicare-eligible City of New York retirees across the United States will transition to the NYC Medicare Advantage Plus plan and have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

BlueHPN to expand in California for 2022

Well-child visits: Know the numbers

Change in claim and customer service administration for Butte Schools

CLARIFICATION to reimbursement policy updates: Virtual visits – professional and facility

Reminder: Pharmacy benefit change for CalPERS PPO members, effective January 2022

2022 Federal Employee Plan® benefit information available online

Botox® update for Anthem Blue Cross members

2021 CAHPS Survey results

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

Keep up with Medi-Cal news – January 2022

• Pharmacy services to be fee-for-service benefit
• Prior authorization updates for medications billed under the medical benefit

Important update on Botox® for Medicare members of Anthem Blue Cross

Los Angeles City Employees’ Retirement System adds the medical and prescription drug plan

Northern California Cement Masons, California moves to Medicare Advantage plan

Professional claims – billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

Keep up with Medicare news – January 2022

• AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
• Medical step therapy updates
• Anthem Blue Cross expands specialty pharmacy precertification list

Important update on Botox® for Medicare members of Anthem Blue Cross

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

Anthem Blue Cross expands specialty pharmacy precertification list