Colorado
Provider Communications

Articles

Title Publication Category Date

Working with Anthem Webinars -- October 2019 schedule: Provider Enrollment Application tool on Availity

October Working with Anthem Webinar: New Provider Enrollment Application tool overview - Colorado Administrative Oct 10, 2019

Pre-certification request turnaround times for the Federal Employee Program

October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Keep up with Medicare news

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Anthem specialty pharmacy medical step therapy drug list- clarification

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Important update to Anthem’s commercial drug lists

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Anthem launches additional changes to anthem.com

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Drug fee schedule update

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

National Accounts 2020 Pre-certification list

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program continues

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Anthem engages Matrix to conduct mobile health clinics and in-home assessments for targeted members

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News and Important Updates - Colorado Medicare Oct 1, 2019

Pharmacy information available on anthem.com

October 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2019

Pre-certification/Pre-authorization requirement changes effective January 1, 2020 (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Working with Anthem Webinars -- October 2019 schedule: Provider Enrollment Application tool on Availity

October 2019 Anthem Provider News and Important Updates - Colorado Administrative Oct 1, 2019

Place of Service (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Oct 1, 2019

Federal Employee Program® Specialty Pharmacy Clinical Site of Care prior authorization review (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Oct 1, 2019

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

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

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

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

PCP after-hours access requirements

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Provider Transparency Update

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Coming soon: electronic attachments

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Keep up with Medicare news

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Anthem expands specialty pharmacy prior authorization list (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Sep 1, 2019

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

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

Access requirements for Behavioral Healthcare services

September 2019 Anthem Provider News and Important Updates - Colorado Administrative Sep 1, 2019

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

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Sep 1, 2019

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

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Sep 1, 2019

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

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

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

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Sep 1, 2019

Changes to PA requirements

September 2019 Anthem Provider News and Important Updates - Colorado Medicare Sep 1, 2019

Anthem launches additional changes to anthem.com for Provider Manuals

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

New service types added to Availity

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Special needs plans -- provider training required

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Keep up with Medicare news

August 2019 Anthem Provider News and Important Updates - Colorado Medicare Aug 1, 2019

Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

Pharmacy information available at anthem.com

August 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2019

Non-participating lab referrals

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

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

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

August 2019 Anthem Provider News and Important Updates - Colorado Administrative Aug 1, 2019

Anthem customizations to MCG care guidelines 23rd edition (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Aug 1, 2019

Bundled Services (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Aug 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Aug 1, 2019

UPDATE: new Rehabilitative Program remains temporarily delayed - Colorado

UPDATE: new Rehabilitative Program remains temporarily delayed - Colorado Administrative Jul 16, 2019

UPDATE: new Rehabilitative Program now effective August 1, 2019 - Colorado

UPDATE: new Rehabilitative Program now effective August 1, 2019 - Colorado Administrative Jul 3, 2019

Clinical criteria updates for specialty pharmacy

July 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Jul 1, 2019

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
July 2019 Anthem Provider News and Important Updates - Colorado Medical Policy & Clinical Guidelines Jul 1, 2019

Update to Provider/Facility UM reimbursement penalties and corresponding update to Provider/Facility Manual (MAC)

Material Adverse Change (MAC)
July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

Working with Anthem Webinars - July 2019 schedule: Networks Overview

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression - What’s in it for you and your patients?

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

Clinical Criteria coding updates for specialty pharmacy are available

July 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Jul 1, 2019

Drug fee schedule update

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

Make the move to the Availity EDI Gateway today

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jul 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Jul 1, 2019

Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

July 2019 Anthem Provider News and Important Updates - Colorado Federal Employee Plan (FEP) Jul 1, 2019

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Provider News and Important Updates - Colorado Medicare Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News and Important Updates - Colorado Medicare Jul 1, 2019

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News and Important Updates - Colorado Medicare Jul 1, 2019

Keep up with Medicare news

July 2019 Anthem Provider News and Important Updates - Colorado Medicare Jul 1, 2019

Changes coming this month with Anthem’s Provider Newsletter and Important Updates

July 2019 Anthem Provider News and Important Updates - Colorado Administrative Jun 28, 2019

Anthem to acquire Beacon Health Options

N/A Administrative Jun 18, 2019

Ambulance Transportation (Professional Reimbursement Policy - New)

June 2019 Anthem Important Updates - Colorado Reimbursement Policies Jun 1, 2019

Anthem expands specialty pharmacy prior authorization list

June 2019 Anthem Important Updates - Colorado Pharmacy Jun 1, 2019

Clinical Validation (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Colorado Reimbursement Policies Jun 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Colorado Reimbursement Policies Jun 1, 2019

Medical Policy and Clinical UM Guidelines notification letter

June 2019 Anthem Important Updates - Colorado Medical Policy & Clinical Guidelines Jun 1, 2019

Anthem Announces Changes in Medical Non-Oncology Specialty Drug Reviews Effective June 15, 2019

June 2019 Anthem Provider Newsletter - Colorado Pharmacy Jun 1, 2019

AIM programs may require additional pre-certification documentation

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Anthem launches additional changes to anthem.com for Q2

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Coming Soon: Anthem Electronic Attachments

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

New ICR Immediate Decision List posted on Availity Payer Spaces

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Find A Doctor -- New Sort Option

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Update: Sepsis Coding

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Anthem Provider Newsletter - Colorado Medicare Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Colorado Medicare Jun 1, 2019

Keep up with Medicare news

June 2019 Anthem Provider Newsletter - Colorado Medicare Jun 1, 2019

Pharmacy information available at anthem.com

June 2019 Anthem Provider Newsletter - Colorado Pharmacy Jun 1, 2019

Update and Reminder: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019

Working with Anthem Webinars - June 2019 schedule: Anthem 101 / Provider Orientation

June 2019 Anthem Provider Newsletter - Colorado Administrative Jun 1, 2019
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