Colorado
Provider Communications

Provider Spotlight

Sep 18, 2020

Information from Anthem for Care Providers about COVID-19 (Updated September 18, 2020)

We recently updated FAQs about cost share waivers for telehealth and telephonic-only care.

Sep 1, 2020

Anthem Chat: A fast, easy way to have your questions answered

Sep 1, 2020

Enhanced Medical Records Submission Process to Support Claims Processing


Articles Recent

Title Publication Category Date

Information from Anthem for Care Providers about COVID-19 (Updated September 18, 2020)

We recently updated FAQs about cost share waivers for telehealth and telephonic-only care.
COVID-19 Information - Colorado Administrative Sep 18, 2020

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

September 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Sep 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

September 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Sep 1, 2020

Anthem Chat: A fast, easy way to have your questions answered

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

EDI Gateway Migration Deadline is September 15, 2020

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Enhanced Medical Records Submission Process to Support Claims Processing

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Patient360 Adds Care Gap Alert Feedback for Medical Providers

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Receive and respond to medical record requests for postpay audit via Change Healthcare’s Attach Assist functionality

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program Continues

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Medical drug benefit Clinical Criteria updates (May 2020)

September 2020 Anthem Provider News and Important Updates -- Colorado Medicare Sep 1, 2020

Site of Care* medical necessity reviews expand to numerous surgical procedures begin December 1, 2020 (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Sep 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Sep 1, 2020

Working with Anthem Webinars -- September 2020 schedule: Provider Claim Questions/Issue Resolution Process Flow

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

New provider directory indicators for medication assisted treatment (MAT) providers

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

National Account members living in Colorado utilizing the Pathway network

September 2020 Anthem Provider News and Important Updates -- Colorado Administrative Sep 1, 2020

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Sep 1, 2020

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

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Sep 1, 2020

Keep up with Medicare news

September 2020 Anthem Provider News and Important Updates -- Colorado Medicare Sep 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Working with Anthem Webinars -- August 2020 schedule: Quick Tips for adding, changing, terming a provider using the Provider Maintenance Form

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Quick Tips: adding, changing, terming a provider using the Provider Maintenance Form

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Change Notification to Provider and Facility Manual effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Expansion of AIM Musculoskeletal Program Effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Commercial Risk Adjustment (CRA): Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Non-participating lab referrals

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Migrate Your EDI Transactions to Availity Today

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Anthem Electronic Attachments -- X12 275 5010

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Prior Authorization/Referral Request and Inpatient Admission/Discharge Notification transactions coming soon

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Clinical Laboratory Improvement Amendments (CLIA) ID number required for electronic claims submissions

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Updated Escalation Contact List -- Colorado

August 2020 Anthem Provider News and Important Updates -- Colorado Administrative Aug 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Aug 1, 2020

Medical Record Standards

August 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement policy update -- Claims Requiring Additional Documentation (Facility)

August 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Aug 1, 2020

Medical drug benefit Clinical Criteria updates

August 2020 Anthem Provider News and Important Updates -- Colorado Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News and Important Updates -- Colorado Medicare Aug 1, 2020

New MCG Care Guidelines 24th edition

August 2020 Anthem Provider News and Important Updates -- Colorado Medicare Aug 1, 2020

AIM Musculoskeletal program expansion

August 2020 Anthem Provider News and Important Updates -- Colorado Medicare Aug 1, 2020

Keep up with Medicare news

August 2020 Anthem Provider News and Important Updates -- Colorado Medicare Aug 1, 2020

Updated Coverage for HIV PrEP medications

July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

Drug fee schedule update

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Commercial Risk Adjustment (CRA) 2020 Program Year Progression: What’s in it for you and your patients?

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jul 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News and Important Updates -- Colorado Federal Employee Plan (FEP) Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Medical drug benefit Clinical Criteria updates

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

UPDATE: New Go Live Date for Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures

July 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jul 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

Working with Anthem Webinars -- July 2020 schedule: Anthem Networks Overview

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Provider claim questions/issue resolution process flow for Colorado -- Commercial members

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

Updated Prefix Reference List -- Colorado

July 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jul 1, 2020

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations (MAC)

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jul 1, 2020

Provider claim questions/issue resolution process flow for Colorado -- Medicare members

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Keep up with Medicare news

July 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jul 1, 2020

Webinar recording now available for network providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond.

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Colorado Behavioral Health Jun 25, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated June 9, 2020)

We are extending coverage for telehealth and telephone-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Colorado Administrative Jun 9, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated June 3, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Colorado Administrative Jun 3, 2020

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Anthem enhances process for submitting Behavioral Health Authorizations

June 2020 Anthem Provider News and Important Updates -- Colorado Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News and Important Updates -- Colorado Behavioral Health Jun 1, 2020

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Quality Corner: CPT® Category II codes – Collaborating for enhanced patient care

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

Keep up with Medicare news

June 2020 Anthem Provider News and Important Updates -- Colorado Medicare Jun 1, 2020

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jun 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jun 1, 2020

Pharmacy information available on anthem.com

June 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jun 1, 2020

Working with Anthem Webinars -- June 2020 schedule: Anthem onboarding for physical health and behavioral health providers

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Reminder: CU Health Plan and UCHealth changes effective July 1, 2020

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Updated Escalation Contact List -- Colorado

June 2020 Anthem Provider News and Important Updates -- Colorado Administrative Jun 1, 2020

Transition to AIM Clinical Appropriateness Guidelines -- Rehabilitative Services (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Jun 1, 2020

Nurse Practitioner and Physician Assistant Service (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Colorado Administrative May 29, 2020

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Colorado Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Colorado Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Reminder about System Updates

May 2020 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

Keep up with Medicare news

May 2020 Anthem Provider News and Important Updates -- Colorado Medicare May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy May 1, 2020

COVID-19 information repository for Anthem care Providers

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

CU Health Plan and UCHealth changes effective July 1, 2020

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Working with Anthem Webinars -- May 2020 schedule: CU Health Plan and UCHealth changes effective July 1, 2020

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Updated Escalation Contact List -- Colorado

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Non-participating lab referrals

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News and Important Updates -- Colorado Administrative May 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020

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

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines May 1, 2020
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