Colorado
Provider Communications


Articles Recent

Title Publication Category Date

Coding Tip for Psychological and Neuropsychological Testing

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Case Management Program

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Coordination of Care

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Retrieve your Anthem Patient’s HEDIS® care gaps through Patient360 located on the Availity Portal

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

System updates for 2020 (Professional)

December 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Dec 1, 2019

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News and Important Updates - Colorado Medicare Dec 1, 2019

Pharmacy information available on anthem.com

December 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Dec 1, 2019

Working with Anthem Webinars -- January 2019 schedule: Pathway PPO Overview

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Non-participating lab referrals

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Important Information about Utilization Management

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Members’ Rights and Responsibilities

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2019 Anthem Provider News and Important Updates - Colorado Administrative Dec 1, 2019

Medical Policy and Clinical UM Guidelines notification (MAC)

Material Adverse Change (MAC)
December 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Dec 1, 2019

New Reimbursement Policies (Professional): Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers

December 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Dec 1, 2019

Coordination of Benefits for an FEP® member

December 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Dec 1, 2019

Keep up with Medicare news

December 2019 Anthem Provider News and Important Updates - Colorado Medicare Dec 1, 2019

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

November 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Nov 1, 2019

Anthem appropriate coding helps provide a comprehensive picture of patients’ health

November 2019 Anthem Provider News and Important Updates - Colorado Administrative Nov 1, 2019

Additional improvements coming to anthem.com regarding Medical Policies and Clinical Guidelines

November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement (APM ID 0037943)

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Prior authorization requirements changes effective November 1, 2019

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Nov 1, 2019

Working with Anthem Webinars -- November 2019 schedule: Provider Maintenance Form

November 2019 Anthem Provider News and Important Updates - Colorado Administrative Nov 1, 2019

Provider Action Needed: verify your information is correct, and update us with any changes utilizing our online Provider Maintenance Form

November 2019 Anthem Provider News and Important Updates - Colorado Administrative Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging of the Abdomen and Pelvis (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Therapy (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program Spine Surgery (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

November 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Nov 1, 2019

Keep up with Medicare news

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 1, 2019

Enhanced search and download options allow easy access to information at your fingertips

Get the latest critical information from Anthem that impacts you; View Provider News for easy access at your fingertips - Colorado Administrative Oct 25, 2019

Working with Anthem Webinars -- October 2019 schedule: Provider Enrollment Application tool on Availity

October Working with Anthem Webinar: New Provider Enrollment Application tool overview - Colorado Administrative Oct 10, 2019

Pre-certification request turnaround times for the Federal Employee Program

October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Keep up with Medicare news

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Anthem specialty pharmacy medical step therapy drug list- clarification

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Important update to Anthem’s commercial drug lists

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Anthem launches additional changes to anthem.com

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Drug fee schedule update

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

National Accounts 2020 Pre-certification list

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program continues

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Anthem engages Matrix to conduct mobile health clinics and in-home assessments for targeted members

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Pharmacy information available on anthem.com

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Pre-certification/Pre-authorization requirement changes effective January 1, 2020 (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Working with Anthem Webinars -- October 2019 schedule: Provider Enrollment Application tool on Availity

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Place of Service (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Oct 1, 2019

Federal Employee Program® Specialty Pharmacy Clinical Site of Care prior authorization review (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

Anthem launches Sydney on September 1; New app offers better digital health care support to members

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

PCP after-hours access requirements

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Provider Transparency Update

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Coming soon: electronic attachments

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Keep up with Medicare news

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Anthem expands specialty pharmacy prior authorization list (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Sep 1, 2019

Working with Anthem Webinars -- September 2019 schedule: Anthem 101/Provider Orientation for Behavioral Health Providers

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Access requirements for Behavioral Healthcare services

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019 (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Sep 1, 2019

Pre-Service/Prior Authorization Clinical Review Update -- September 2019 (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Sep 1, 2019

Maternity Services and Multiple Delivery (Professional Reimbursement Policies – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Intensity Modulated Radiation Therapy Planning and Delivery (Professional Reimbursement Policy – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Changes to PA requirements

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Anthem launches additional changes to anthem.com for Provider Manuals

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

New service types added to Availity

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Special needs plans -- provider training required

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Keep up with Medicare news

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

Pharmacy information available at anthem.com

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

Non-participating lab referrals

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Working with Anthem Webinars - August 2019 schedule: Anthem 101/Provider Orientation for Behavioral Health Providers

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Anthem customizations to MCG care guidelines 23rd edition (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Bundled Services (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Aug 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Aug 1, 2019

UPDATE: new Rehabilitative Program remains temporarily delayed - Colorado

UPDATE: new Rehabilitative Program remains temporarily delayed - Colorado Administrative Jul 16, 2019

UPDATE: new Rehabilitative Program now effective August 1, 2019 - Colorado

UPDATE: new Rehabilitative Program now effective August 1, 2019 - Colorado Administrative Jul 3, 2019

Clinical criteria updates for specialty pharmacy

July 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Jul 1, 2019

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
July 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Jul 1, 2019
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