Colorado
Provider Communications

September 2019 Anthem Provider News and Important Updates - Colorado

Download as PDF

Title Category

Anthem expands specialty pharmacy prior authorization list (MAC)

Material Adverse Change (MAC)
Pharmacy

Working with Anthem Webinars -- September 2019 schedule: Anthem 101/Provider Orientation for Behavioral Health Providers

Administrative

Anthem launches Sydney on September 1; New app offers better digital health care support to members

Administrative

Reminder: Changes to timely filing requirements coming in October

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

Administrative

Access requirements for Behavioral Healthcare services

Administrative

PCP after-hours access requirements

Administrative

Provider Transparency Update

Administrative

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019 (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Pre-Service/Prior Authorization Clinical Review Update -- September 2019 (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Maternity Services and Multiple Delivery (Professional Reimbursement Policies – New) (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Intensity Modulated Radiation Therapy Planning and Delivery (Professional Reimbursement Policy – New) (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Claim editing update for Excludes1 notes

Reimbursement Policies

Claims requiring additional documentation facility reimbursement policy update

Reimbursement Policies

Coming soon: electronic attachments

Medicare

Clinical Criteria updates

Medicare

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare

Pharmacy benefit manager change to IngenioRx

Medicare

Changes to PA requirements

Medicare

Keep up with Medicare news

Medicare
Page 1 of 1