We are continuing our series of “Working with Anthem” webinars for 2020.  These webinars are focused on one topic each session, and designed to help our providers and their staff learn how to use the tools currently available to improve operational efficiency when working with Anthem Blue Cross and Blue Shield (Anthem).

2020 Subject Specific Webinars -- October schedule

 

Topic:	Pathway Essentials
Date/Time:	Wednesday, October 28, 2020, 12-1pm MT
Description:	Join our webinar to learn more about details such as: ·  what is the Pathway Essentials Network ·  how do I know if I'm participating ·  how to identify members aligned with this network ·  sample member ID cards ·  plus more
Registration link:	https://anthem.webex.com/anthem/onstage/g.php?PRID=b6a696587e498199466cadc7231c908d

 

Webinars are offered using Cisco WebEx. There is no cost to attend.  Access to the internet, an email address and telephone is all that's needed.  Attendance is limited, so please register today.

 

Watch for additional topics and dates in future issues of our monthly provider newsletter throughout the year.  We also will continue to offer our Fall Provider Seminars which will continue to cover a variety of topics in face-to-face and webinar options.

 

Recorded sessions: 

Most sessions are recorded and playback versions are available on our Registration Page.  The top portion of the page will show “Upcoming Events” and the bottom portion will show “Event Recordings”.

 

Note:  Even if you are unavailable to attend, please register to ensure you receive the event recording password once available as it’s distributed to all that register. 

 

 

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In anticipation of Anthem Blue Cross and Blue Shield and HMO Colorado Inc. (Anthem) open enrollment period this fall, we continue to develop networks to support new product offerings.  We will be offering a new narrow HMO network for the Individual and Small Group market in select counties in the Denver Metro and Boulder market. 

 

The Pathway Essentials network will be an HMO narrow network, available in the following counties: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Clear Creek, Elbert, Gilpin, Jefferson and Park.   Note:  this is a subset of our Pathway HMO network which is still in effect as a statewide network in Colorado.

 

Our Pathway Essentials network is aligned with the following hospital systems:

 

• Boulder Community Hospital
• HCA
• Medical Center of Aurora
• North Suburban Medical Center
• Presbyterian/St. Luke’s Medical Center
• Rose Medical Center
• Sky Ridge Medical Center
• Swedish Medical Center
• Spalding Rehabilitation Hospital
• Rocky Mountain Hospital for Children (HCA)
• Craig Hospital

 

Note: The Pathway Essentials network includes all behavioral health, ABA (autism), and ancillary providers (PT/OT/ST, home infusion, home health, DME, lab) in our standard HMO network, unless affiliated with a non-participating hospital system, as well as American Specialty Health (vendor for Chiropractic, Acupuncture, and Registered Dieticians).

 

Important Distinction:  While “Pathway” is included in the network name, Pathway Essentials is a separate network from our Pathway HMO network.  But, providers participating in the Pathway Essentials network, must also be participating in the Pathway HMO network. 

 

Anthem sent Amendments in July to those providers that will be participating in the Pathway Essentials network in addition to their continued participation in the Pathway HMO network.  The reimbursement rates for the Pathway Essentials HMO network will be the same as the Pathway HMO reimbursement rates. 

 

Identifying Members accessing the Pathway Essentials Network:

 

Three-Character Prefix	Health Benefits Plan Option	Product Type	Network Name (On Member ID cards)
P4E, X4X	Individual	HMO	Pathway Essentials
P3Y	Small Group	HMO	Pathway Essentials
P3S	Anthem Balance Funding (ABF)	HMO	Pathway Essentials

  

Pathway Essentials sample Member ID card

 

 

Provider Webinar opportunities featuring the Pathway Essentials Network

 

We will be conducting a “Working with Anthem” webinar regarding the Pathway Essentials on Wednesday, October 28, 2020 at 12pm MT.  Please join us to learn about our new Pathway Essentials network and the new products available to access this network starting January 1, 2021.

 

Webinar Registration link:  Register for a Working with Anthem Webinar.  Webinars are recorded. Even if you are not able to attend on the scheduled date, please register to ensure you receive event recording details once available.

 

Thank you for the care you provide to our members.

 

 

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