Colorado
Provider Communications

March 2020 Anthem Provider News and Important Updates -- Colorado

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Title Category

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020 (MAC)

Material Adverse Change (MAC)
Products & Programs

Pharmacy information available on anthem.com

Pharmacy

Working with Anthem Webinars -- March 2020 schedule: Availity tools and functionality overview

Administrative

Provider News site enhancements

Administrative

Commercial Risk Adjustment (CRA) Program Update: Medical chart collection for ACA members due March 31, 2020

Administrative

Modifier use reminders

Administrative

Updated Escalation Contact List -- Colorado

Administrative

Updated Prefix Reference List -- Colorado

Administrative

Important coding reminder for Walk-In Retail Health Clinics

Administrative

Patient360 enhancement for medical providers

Administrative

Clinical guideline update effective June 1, 2020 -- CG-SURG-92 / Paraesophageal Hernia Repair (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG -- W0163 Pelvic Organ Prolapse Repair

Medical Policy & Clinical Guidelines

Reminder: Mid-level practitioners are required to file using their NPI

Reimbursement Policies

Outpatient Rehabilitation Program transition: new prior authorization requirements

Medicare

Reminder: Mid-level practitioners are required to file using their NPI

Medicare

Nonpreferred products and corresponding preferred alternatives

Medicare

Keep up with Medicare news

Medicare
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