Correction: Change notification to Provider and Facility Manual effective December 1, 2022
As of today, the new manual is available online:
- Go to anthem.com and select Providers.
- Under the Provider Resources heading, select Policies, Guidelines, and Manuals.
- Select Colorado if you haven’t done so already.
To access the manual effective December 1, 2022:
- Under the Provider Manual heading, select Download the Manual under the banner.
- This version is effective beginning December 1, 2022, but available for review as of September 1, 2022.
To access the manual still effective until August 31, 2022:
- Select the link titled Access previous versions and other manuals.
- See the appropriate historical version using the effective dates listed with each manual.
Please note that the manual is available in a PDF version for ease of printing, but we encourage you to view online or only print individual sections to help conserve paper.
Changes were made to the following sections:
- Insurance requirements
- Claims submission
- Medical records submission (solicited and unsolicited)
- Electronic data interchange (EDI)
- Claim payment disputes
- Clinical appeals
- Reimbursement requirements and policies
- Medical Policies and Clinical Utilization Management (UM) Guidelines
- Utilization management
- AIM Specialty Health®*
- Quality Improvement Program
- Member rights and responsibilities
- Overview of HEDIS®
- Centers of Medical Excellence
- Audit and review
- Fraud, waste, abuse, and detection
Thank you for your continued participation in our network.
December 2022 Anthem Provider News - Colorado