Colorado
Provider Communications

June 2021 Anthem Provider News and Important Updates - Colorado

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Title Category

Let’s Vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies.
Products & Programs

Medical Policy and Clinical UM Guidelines Notice (MAC)

Material Adverse Change (MAC)

Medical Policy & Clinical Guidelines

New back pain management program effective July 19, 2021

Products & Programs

Updates to AIM Advanced Imaging Clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)

Products & Programs

Updates to AIM Musculoskeletal program clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)

Products & Programs

Pharmacy information available on anthem.com

Pharmacy

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

Material Adverse Change (MAC)

Pharmacy

Regular check-ins with your clearinghouse could affect timely filing

Administrative

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

Administrative

Keep your contact information current

Administrative

Working with Anthem webinars – June 2021 schedule: Provider orientation for physical health and behavioral health providers

Administrative

Two great learning resources on one secure portal

Digital Tools

Digital solution options with Availity

Digital Tools

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Digital Tools

Essential information you need to submit EDI corrected claims

Digital Tools

Anthem to enhance claim edits for outpatient facility claims

Reimbursement Policies

DEXA bone scan criteria for the Federal Employee Program

Federal Employee Plan (FEP)

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

Medicare

MCG care guidelines 25th edition

Medicare

Medical drug benefit clinical criteria updates

Medicare

Medical policies and clinical utilization management guidelines update

Medicare

Reminders for Medicare Advantage group retiree PPO plans and national access plus FAQ

Medicare
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