CommercialJuly 1, 2021
July 2021 Anthem Provider News and Important Updates - Colorado
Administrative
CommercialJuly 1, 2021
Drug fee schedule updateCommercialJuly 1, 2021
Important update to provider UM reimbursement penalties and corresponding entry in Provider ManualCommercialJuly 1, 2021
Clinical quality in practice: CME webinar seriesCommercialJuly 1, 2021
Proper coding for in-home monitoring can make a measurable difference for INRCommercialJuly 1, 2021
Company to retire Blue Precision program at the end of the yearCommercialJuly 1, 2021
Timely receipt of the primary payer’s EOB can help reduce timely filing denials for secondary claimsCommercialJuly 1, 2021
Another mark of the pandemic: An increase in childhood obesityMore potato chips, sugary drinks and less physical activity are key contributors
CommercialJuly 1, 2021
Working with Anthem webinars – July 2021 schedule: Anthem networks overviewCommercialJuly 1, 2021
Interactive Care Reviewer (ICR): New search option for cases submitted through ICRCommercialJuly 1, 2021
How to enroll in electronic fund transfer for faster remittanceCommercialJuly 1, 2021
Electronic claim response filesPolicy Updates
CommercialJuly 1, 2021
Site-of-Care medical necessity reviews for long-acting colony-stimulating factors will not be implemented on August 1, 2021 (MAC)CommercialJuly 1, 2021
Pre-Service / Prior Authorization Clinical Review Update: July 2021 (MAC)CommercialJuly 1, 2021
New reimbursement policy: Non-patient laboratory services - facility (MAC)Products & Programs
CommercialJuly 1, 2021
Reminder: Back pain guide program, effective July 19, 2021CommercialJuly 1, 2021
Reminder: Updated AIM rehabilitative program, effective August 1, 2021 – and site of service reviewsCommercialJuly 1, 2021
Anthem prior authorization updates for specialty pharmacy are available (MAC)State & Federal
Medicare AdvantageJuly 1, 2021
Reimbursement policy reminder: Inpatient readmissionsMedicare AdvantageJuly 1, 2021
Updates to the AIM advanced imaging clinical appropriateness guidelinesMedicare AdvantageJuly 1, 2021
New reimbursement policy – Modifier 90: Reference (outside) laboratory and pass-through billingMedicare AdvantageJuly 1, 2021
Prior authorization requirement changes effective September 1, 2021 – UM AROW 1845Medicare AdvantageJuly 1, 2021
Let’s vaccinateHelp increase your vaccination rates and close gaps-in-care with these tools and strategies
Medicare AdvantageJuly 1, 2021
Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428Medicare AdvantageJuly 1, 2021
Medical drug benefit clinical criteria updatesTo view this publication online:
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