Colorado
Provider Communications

Articles

Title Publication Category Date

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program begins; benefits of direct connection access to your EMR

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

CORRECTION: Notice regarding post-pay review of ER claims

CORRECTION: Notice regarding post-pay review of ER claims - Colorado Reimbursement Policies May 16, 2019

Working with Anthem Webinars - May 2019 schedule: Availity Tools and Functionality Overview

Working with Anthem Webinars - May 2019 schedule: Availity tools and functionality overview - Colorado Administrative May 10, 2019

Anthem expands specialty pharmacy medical step therapy drug list

May 2019 Anthem Important Updates - Colorado Pharmacy May 1, 2019

MCG care guidelines 23rd Edition and Anthem customizations

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

Anthem specialty pharmacy medical step therapy drug list clarification about non-oncology colony stimulating factor agents

May 2019 Anthem Provider Newsletter - Colorado Pharmacy May 1, 2019

Working with Anthem Webinars - May 2019 schedule: Availity Tools and Functionality Overview

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

Electronic Member ID Cards - Easy online access on the Availity Portal

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

Updated Escalation Contact List

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Health Assessment requests for 2019 / Alternative reporting engagement

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

Anthem Contracted Ambulance Providers

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

New Benefit / Service types added to the Eligibility and Benefits Inquiry tool in the Availity Portal

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

ATTENTION! Availity launches additional changes to the new look to our Medical Attachment submission tool

May 2019 Anthem Provider Newsletter - Colorado Administrative May 1, 2019

Review of professional claims with emergency room level 5 E/M codes - *CORRECTION: For more information, refer to article published May 16, 2019.

May 2019 Anthem Provider Newsletter - Colorado Reimbursement Policies May 1, 2019

Drug Screen Testing (Professional Reimbursement Policy - Updated)

May 2019 Anthem Provider Newsletter - Colorado Reimbursement Policies May 1, 2019

Fall prevention tips

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Medical records request for risk adjustment

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Modifier 63: Procedure Performed on Infants Less Than 4 kg - Policy 06-015

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Partial hospitalization services

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Keep up with Medicare news

May 2019 Anthem Provider Newsletter - Colorado Medicare May 1, 2019

Update: Temporarily retracting roll out of Availity Claim Payment dispute tool for Commercial claims - Colorado

Update: Temporarily retracting roll out of Availity Claim Payment dispute tool for Commercial claims - Colorado Administrative Apr 5, 2019

Working with Anthem Webinars - April 2019 schedule: new Digital Provider Enrollment Application tool and Provider Maintenance Form

Working with Anthem Webinars - April 2019 schedule: new Digital Provider Enrollment Application tool and Provider Maintenance Form - Colorado Administrative Apr 5, 2019

Anthem’s new Digital Provider Enrollment application - now available

Working with Anthem Webinars - April 2019 schedule: new Digital Provider Enrollment Application tool and Provider Maintenance Form - Colorado Administrative Apr 5, 2019

Anthem expands specialty pharmacy prior authorization list

April 2019 Anthem Important Updates - Colorado Pharmacy Apr 1, 2019

New AIM Rehabilitation program effective July 1, 2019

April 2019 Anthem Important Updates - Colorado Administrative Apr 1, 2019

Partial Hospitalization and Intensive Outpatient Program Services (Facility Reimbursement Policy - New)

April 2019 Anthem Important Updates - Colorado Reimbursement Policies Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Advanced Imaging of the Head and Neck

April 2019 Anthem Important Updates - Colorado Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Advanced Imaging of the Heart

April 2019 Anthem Important Updates - Colorado Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Musculoskeletal Joint Surgery

April 2019 Anthem Important Updates - Colorado Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Sleep Disorder Management

April 2019 Anthem Important Updates - Colorado Medical Policy & Clinical Guidelines Apr 1, 2019

Pharmacy information available at anthem.com

April 2019 Anthem Provider Newsletter - Colorado Pharmacy Apr 1, 2019

Drug fee schedule update

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Working with Anthem Webinars - April 2019 schedule: new Digital Provider Enrollment Application tool and Provider Maintenance Form

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Anthem’s new Digital Provider Enrollment application - now available

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

New look to our Medical Attachment submission tool

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Non-participating lab referrals

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Updated Escalation Contact List

April 2019 Anthem Provider Newsletter - Colorado Administrative Apr 1, 2019

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

April 2019 Anthem Provider Newsletter - Colorado Medicare Apr 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Anthem Provider Newsletter - Colorado Medicare Apr 1, 2019

Electronic claim payment reconsideration

April 2019 Anthem Provider Newsletter - Colorado Medicare Apr 1, 2019

Keep up with Medicare news

April 2019 Anthem Provider Newsletter - Colorado Medicare Apr 1, 2019
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