CommercialSeptember 1, 2019

September 2019 Anthem Provider News and Important Updates - Colorado

Administrative

AdministrativeCommercialAugust 31, 2019

Provider Transparency Update

AdministrativeCommercialAugust 31, 2019

PCP after-hours access requirements

AdministrativeCommercialAugust 31, 2019

Access requirements for Behavioral Healthcare services

AdministrativeCommercialAugust 31, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

AdministrativeCommercialAugust 31, 2019

Reminder: Changes to timely filing requirements coming in October

AdministrativeCommercialAugust 31, 2019

Anthem launches Sydney on September 1; New app offers better digital health care support to members

AdministrativeCommercialAugust 31, 2019

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

Policy Updates

Medical Policy & Clinical GuidelinesCommercialAugust 31, 2019

Pre-Service/Prior Authorization Clinical Review Update -- September 2019 (MAC)
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialAugust 31, 2019

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019 (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialAugust 31, 2019

Maternity Services and Multiple Delivery (Professional Reimbursement Policies – New) (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialAugust 31, 2019

Claims requiring additional documentation facility reimbursement policy update

Reimbursement PoliciesCommercialAugust 31, 2019

Claim editing update for Excludes1 notes

Reimbursement PoliciesCommercialAugust 31, 2019

Intensity Modulated Radiation Therapy Planning and Delivery (Professional Reimbursement Policy – New) (MAC)
Material Adverse Change (MAC)

Products & Programs

PharmacyCommercialAugust 31, 2019

Anthem expands specialty pharmacy prior authorization list (MAC)
Material Adverse Change (MAC)

State & Federal

State & FederalMedicare AdvantageAugust 31, 2019

Keep up with Medicare news

State & FederalMedicare AdvantageAugust 31, 2019

Changes to PA requirements

State & FederalMedicare AdvantageAugust 31, 2019

Pharmacy benefit manager change to IngenioRx

State & FederalMedicare AdvantageAugust 31, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

State & FederalMedicare AdvantageAugust 31, 2019

Clinical Criteria updates

State & FederalMedicare AdvantageAugust 31, 2019

Coming soon: electronic attachments