Colorado
Provider Communications

December 2021 Anthem Provider News and Important Updates - Colorado

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Title Category

Non-par lab referrals

Administrative

Update: Anthem Blue Cross and Blue Shield to implement provider claim payment dispute process for Commercial lines of business has been delayed

Administrative

Professional system updates for 2022

Administrative

Outpatient system updates for 2022

Administrative

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Administrative

Anthem to retire Blue Precision program at the end of the year

Administrative

Behavioral healthcare appointment access requirements

Administrative

Importance of PCP after-hours messaging

Administrative

Chlamydia is asymptomatic. Only through screening will we know for sure

Administrative

Case Management Program

Administrative

Member rights and responsibilities

Administrative

Coordination of care

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Submitting prior authorizations is getting easier

Anthem Blue Cross and Blue Shield is transitioning to the Availity Authorization app

Administrative

Important information about utilization management

Administrative

Is prior authorization required?

Answering your questions about the new Availity Authorization App
Digital Tools

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem Blue Cross and Blue Shield providers

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021

Digital Tools

Professional reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

New professional reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

RETRACTION: Inpatient Facility Transfers reimbursement policy (facility)

Reimbursement Policies

Reimbursement policy update: Virtual Visits - professional and facility

Reimbursement Policies

Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
Products & Programs

Updates to AIM Specialty Health cardiology clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)
Products & Programs

Updates to AIM Specialty Health radiation oncology clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
Products & Programs

Updates to AIM advanced imaging clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
Products & Programs

Updated AIM Musculoskeletal program site of care reviews delayed

Products & Programs

Pharmacy information available on Anthem.com

Pharmacy

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

Material Adverse Change (MAC)
Pharmacy

Good news: Non-payment remittance advice enhancements are here

Medicare

Policy update: Drug screen testing

Policy update Drug Screen Testing, effective March 1, 2022

Medicare

2022 Medicare Advantage service area and benefit updates

Medicare

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

Medicare

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

Medicare

Somatus is your resource for kidney care management

Medicare

Keep up with Medicare news – December 2021

Medicare
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