Colorado
Provider Communications

November 2019 Anthem Provider News and Important Updates - Colorado

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Title Category

Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
Pharmacy

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Working with Anthem Webinars -- November 2019 schedule: Provider Maintenance Form

Administrative

Provider Action Needed: verify your information is correct, and update us with any changes utilizing our online Provider Maintenance Form

Administrative

Anthem appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

Additional improvements coming to anthem.com regarding Medical Policies and Clinical Guidelines

Medical Policy & Clinical Guidelines

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging of the Abdomen and Pelvis (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Therapy (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program Spine Surgery (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement (APM ID 0037943)

Medicare

CMS reminder: expedited/urgent requests

Medicare

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicare

Prior authorization requirements changes effective November 1, 2019

Medicare

Keep up with Medicare news

Medicare
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