CommercialDecember 1, 2018
December 2018 Anthem Provider Newsletter - CO
Administrative
CommercialNovember 30, 2018
Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)CommercialNovember 30, 2018
Request a Clinical Appeal through new functionality in our Interactive Care Reviewer (ICR) tool on AvailityCommercialNovember 30, 2018
Availity to serve as EDI entry point for electronic submissionsCommercialNovember 30, 2018
Anthem works to simplify payment recovery process for National Accounts membershipCommercialNovember 30, 2018
Non-participating lab referralsCommercialNovember 30, 2018
HEDIS® 2018 Commercial Results Are InCommercialNovember 30, 2018
Plans offered in 2019CommercialNovember 30, 2018
Networks at a GlanceCommercialNovember 30, 2018
Updated Escalation Contact ListCommercialNovember 30, 2018
Updated Prefix Reference ListPolicy Updates
CommercialNovember 30, 2018
Update to AIM Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Restructure of AIM Advanced Imaging Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Updates to AIM Musculoskeletal Surgery Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Reimbursement for Convenience Surgical Supply Kits - ProfessionalCommercialNovember 30, 2018
Scope of License - Reimbursement Policy Update (Professional)CommercialNovember 30, 2018
“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services - ProfessionalCommercialNovember 30, 2018
System updates for reimbursement policies in 2019 - ProfessionalCommercialNovember 30, 2018
Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period - ProfessionalCommercialNovember 30, 2018
Reimbursement Policies are available onlineCommercialNovember 30, 2018
Clear Claim ConnectionProducts & Programs
CommercialNovember 30, 2018
ConditionCare Program Benefits Patients and PhysiciansCommercialNovember 30, 2018
Integrated Care Model for plans purchased on the Health Insurance Marketplace / Connect for Health Colorado benefits patients and physiciansCommercialNovember 30, 2018
Coordination of CareCommercialNovember 30, 2018
Important Information about Utilization ManagementCommercialNovember 30, 2018
Pharmacy information available on anthem.comCommercialNovember 30, 2018
Members’ Rights and ResponsibilitiesCommercialNovember 30, 2018
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the WebCommercialNovember 30, 2018
Clinical Practice and Preventive Health Guidelines available on the webCommercialNovember 30, 2018
Case Management ProgramCommercialNovember 30, 2018
BlueAdvantage HMO on the Pathway HMO Network for Federal EmployeesCommercialNovember 30, 2018
Coordination of Benefits for an FEP® memberCommercialNovember 30, 2018
Pharmacy information available on anthem.comCommercialNovember 30, 2018
Anthem accepts electronic prior authorization requests for prescription medications onlineCommercialNovember 30, 2018
Introducing the new Clinical Criteria page for injectable, infused or implanted drugsState & Federal
Medicare AdvantageNovember 30, 2018
Colorado Public Employees' Retirement Association (PERA) Offers Medicare Advantage OptionMedicare AdvantageNovember 30, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019Medicare AdvantageNovember 30, 2018
2019 Medicare Advantage individual benefits and formulariesMedicare AdvantageNovember 30, 2018
CMS Medicare Preclusion List effective April 1, 2019Medicare AdvantageNovember 30, 2018
When and how to initiate Medicare Advantage reopeningsMedicare AdvantageNovember 30, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Keep up with Medicare newsTo view this publication online:
Visit https://providernews.anthem.com/colorado/publications/december-2018-anthem-provider-newsletter-co-93
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