Colorado
Provider Communications

June 2020 Anthem Provider News and Important Updates -- Colorado

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Title Category

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.
Administrative

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

Products & Programs

Anthem enhances process for submitting Behavioral Health Authorizations

Behavioral Health

Quality Corner: Follow-Up after Hospitalization for Mental Illness

Behavioral Health

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

Material Adverse Change (MAC)
Pharmacy

Pharmacy information available on anthem.com

Pharmacy

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

Administrative

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

Administrative

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

Administrative

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

Administrative

Availity Portal Notification Center

Administrative

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

Administrative

Updated Escalation Contact List -- Colorado

Administrative

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

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

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

Material Adverse Change (MAC)
Reimbursement Policies

Modifier use reminders

Medicare

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

Medicare

2020 Medicare risk adjustment provider trainings

Medicare

Diabetes HbA1c < 8 HEDIS guidance

Medicare

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medicare

Keep up with Medicare news

Medicare
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