CommercialAugust 1, 2019

August 2019 Anthem Provider News and Important Updates - Colorado

Administrative

AdministrativeCommercialJuly 31, 2019

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

AdministrativeCommercialJuly 31, 2019

Non-participating lab referrals

AdministrativeCommercialJuly 31, 2019

Anthem launches additional changes to anthem.com for Provider Manuals

AdministrativeCommercialJuly 31, 2019

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

Policy Updates

Medical Policy & Clinical GuidelinesCommercialJuly 31, 2019

Anthem customizations to MCG care guidelines 23rd edition (MAC)
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJuly 31, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJuly 31, 2019

Medical Policy and Clinical UM Guidelines notification letter (MAC)
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJuly 31, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical GuidelinesCommercialJuly 31, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

Reimbursement PoliciesCommercialJuly 31, 2019

Bundled Services (Professional Reimbursement Policy - Update) (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialJuly 31, 2019

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)
Material Adverse Change (MAC)

Products & Programs

PharmacyCommercialJuly 31, 2019

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

PharmacyCommercialJuly 31, 2019

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

PharmacyCommercialJuly 31, 2019

Pharmacy information available at anthem.com

State & Federal

State & FederalMedicare AdvantageJuly 31, 2019

New service types added to Availity

State & FederalMedicare AdvantageJuly 31, 2019

New Reimbursement Policy: Drug Screen Testing

State & FederalMedicare AdvantageJuly 31, 2019

AIM Specialty Health programs may require documentation

State & FederalMedicare AdvantageJuly 31, 2019

Special needs plans -- provider training required

State & FederalMedicare AdvantageJuly 31, 2019

Keep up with Medicare news