Colorado
Provider Communications

April 2021 Anthem Provider News and Important Updates -- Colorado

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Title Category

UPDATE--Site of Care medical necessity reviews for long-acting colony-stimulating factors begin August 1, 2021 (MAC)

Material Adverse Change (MAC)
Products & Programs

Interactive bilingual website taking action for our health

Products & Programs

Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services

Products & Programs

The heath of millennials: Trends in behavioral health conditions

Behavioral Health

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

Material Adverse Change (MAC)
Pharmacy

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Change Notification to Provider and Facility Manual effective July 1, 2021 (MAC)

Material Adverse Change (MAC)
Administrative

Maximizing efficient, high quality COVID-19 screenings

Administrative

Does your practice offer telehealth services? Let us know!

Administrative

Working with Anthem Webinars -- April 2021 schedule: Enhanced claim question/issue resolution process

Administrative

Payer Spaces: name change announcement

Administrative

Understanding Availity Roles for Electronic Data Interchange (EDI)

Administrative

Make the change to digital authorization/referral and hospital admission notifications using EDI

Administrative

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

Administrative

Chat directly with a Prior Authorization Specialist

Administrative

UPDATE: For Commercial Providers regarding the AIM Sleep Therapy Program CPT Code E1399, NOC: Durable medical equipment, miscellaneous

Administrative

Join Anthem in talking about racism and its impact on health

Administrative

Drug fee schedule update

Administrative

MCG Care Guidelines 25th Edition (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Clinic Charges (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Newborn Inpatient Stays (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

HEDIS 2021 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

In-Office Assessment program

Medicare

Oncology Dose Reduction Program beginning July 1, 2021

Medicare

Clinical Criteria Updates Notification November 2020

Medicare

Clinical Criteria Updates Notification December 2020

Medicare

Does your practice offer telehealth services? Let us know!

Medicare

Keep up with Medicare news

Medicare

Designated Specialty Pharmacy Network

Pharmacy
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