CommercialJanuary 1, 2021

January 2021 Anthem Provider News and Important Updates -- Colorado

Administrative

AdministrativeCommercialDecember 31, 2020

Drug fee schedule update

AdministrativeCommercialDecember 31, 2020

It is almost CAHPS survey time!

AdministrativeCommercialDecember 31, 2020

Evaluation and Management Changes 2021

AdministrativeCommercialDecember 31, 2020

New Blue HPN® plans in effect

AdministrativeCommercialDecember 31, 2020

Self-service, digital transactions are fast and easy

AdministrativeCommercialDecember 31, 2020

Find out in minutes why your claim denied

AdministrativeCommercialDecember 31, 2020

New features added to Interactive Care Reviewer

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 31, 2020

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

Medical Policy & Clinical GuidelinesCommercialDecember 31, 2020

MCG care guidelines 24th Edition Customization (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialDecember 31, 2020

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

Reimbursement PoliciesCommercialDecember 31, 2020

Outpatient System updates for Facility reimbursement policies 2021

Reimbursement PoliciesCommercialDecember 31, 2020

System updates impacting Professional reimbursement policies for 2021

Reimbursement PoliciesCommercialDecember 31, 2020

Multiple Diagnostic Imaging Procedures (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialDecember 31, 2020

Unit Frequency Maximum for Drugs and Biologic Substances (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialDecember 31, 2020

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialDecember 31, 2020

Guidelines for Reporting Timed Units: Physical Medicine and Rehab Services (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Products & Programs

Federal Employee Program (FEP)CommercialDecember 31, 2020

2021 FEP® Benefit information available online

PharmacyCommercialDecember 31, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)
Material Adverse Change (MAC)

PharmacyCommercialDecember 31, 2020

IngenioRx Introduces New Pharmacy Network in 2021

State & Federal

State & FederalMedicare AdvantageDecember 31, 2020

Keep up with Medicare news

State & FederalMedicare AdvantageDecember 31, 2020

2020 Medicare risk adjustment provider trainings

State & FederalMedicare AdvantageDecember 31, 2020

Medical drug benefit Clinical Criteria updates

State & FederalMedicare AdvantageDecember 31, 2020

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines

State & FederalMedicare AdvantageDecember 31, 2020

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging