Colorado
Provider Communications

Articles

Title Publication Category Date

Reimbursement Policies are available online

January 2019 Anthem Provider Newsletter - CO Reimbursement Policies Jan 1, 2019

Clear Claim Connection

January 2019 Anthem Provider Newsletter - CO Reimbursement Policies Jan 1, 2019

Ambulance Transportation (Professional Reimbursement Policy - New)

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

Correction to reimbursement policy: Place of Service – facility (MAC)

November 2022 Anthem Provider News - Colorado Reimbursement Policies Nov 1, 2022

Clinical Validation (Professional Reimbursement Policy - Update)

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

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Nov 1, 2021

Frequency Editing (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Colorado Reimbursement Policies Jun 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

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

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Jan 1, 2021

Emergency Room Transfers (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Feb 1, 2021

Guidelines for Reporting Timed Units: Physical Medicine and Rehab Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Colorado Reimbursement Policies Jan 1, 2021

Let’s Vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies.
June 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jun 1, 2021

Modification to voluntary Cancer Care Quality Program, enhanced reimbursement to begin July 1, 2021

May 2021 Anthem Provider News and Important Updates - Colorado Products & Programs May 1, 2021

New back pain management program effective July 19, 2021

June 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jun 1, 2021

Updates to AIM Advanced Imaging Clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)

June 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jun 1, 2021

Updates to AIM Musculoskeletal program clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)

June 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jun 1, 2021

Reminder: Updated AIM Musculoskeletal Program site of care reviews effective November 1, 2021

October 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Oct 1, 2021

Updated AIM Rehabilitative Program Effective August 1, 2021 – Initial Evaluations and Site of Service Reviews (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News and Important Updates - Colorado Products & Programs May 1, 2021

Some physician requests to AIM require the submission of documentation to support attestations for prior authorization

August 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Aug 1, 2021

Transition to AIM Specialty Health Imaging of the Heart Clinical Appropriateness Guideline for Computed Tomography to Detect Coronary Artery Calcification (MAC)

Material Adverse Change (MAC)
August 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Aug 1, 2021

Updates to AIM Musculoskeletal Program Effective November 1, 2021 – Site of Care Reviews (MAC)

Material Adverse Change (MAC)
August 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Aug 1, 2021

UPDATE: New Go Live Date for Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures

July 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jul 1, 2020

Case Management Program

December 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Dec 1, 2020

Anthem expands hospice benefit

December 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Dec 1, 2020

UPDATE--Site of Care medical necessity reviews for long-acting colony-stimulating factors begin August 1, 2021 (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Colorado Products & Programs Apr 1, 2021

Interactive bilingual website taking action for our health

April 2021 Anthem Provider News and Important Updates -- Colorado Products & Programs Apr 1, 2021

Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services

April 2021 Anthem Provider News and Important Updates -- Colorado Products & Programs Apr 1, 2021

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021 (MAC)

Material Adverse Change (MAC)
March 2021 Anthem Provider News and Important Updates -- Colorado Products & Programs Mar 1, 2021

Provider Transparency Update

March 2019 Anthem Provider Newsletter - CO Products & Programs Mar 1, 2019

Options for helping members avoid ER visits during flu season

November 2018 Anthem Provider Newsletter - CO Products & Programs Nov 1, 2018

Anthem Community Care Coordination expands relationship with Innovative Health Delivery to support commercial members with complex needs

August 2018 Anthem Provider Newsletter - CO Products & Programs Aug 17, 2018

Anthem’s Individualized Care Program supports palliative care for commercial members

August 2018 Anthem Provider Newsletter - CO Products & Programs Aug 17, 2018

Additional Support Available for Members with Rare Conditions

August 2018 Anthem Provider Newsletter - CO Products & Programs Aug 17, 2018

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Jun 1, 2020

Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
December 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Dec 1, 2021

Updates to AIM Specialty Health cardiology clinical appropriateness guidelines (MAC)

Material Adverse Change (MAC)
December 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Dec 1, 2021

Updates to AIM Specialty Health radiation oncology clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
December 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Dec 1, 2021

Updates to AIM advanced imaging clinical appropriateness guideline (MAC)

Material Adverse Change (MAC)
December 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Dec 1, 2021

Updated AIM Musculoskeletal program site of care reviews delayed

December 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Dec 1, 2021

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020 (MAC)

Material Adverse Change (MAC)
March 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Mar 1, 2020

Site of Care* medical necessity reviews expand to numerous surgical procedures begin December 1, 2020 (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Sep 1, 2020

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

September 2020 Anthem Provider News and Important Updates -- Colorado Products & Programs Sep 1, 2020

Case Management Program

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

ConditionCare Program Benefits Patients and Physicians

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Integrated Care Model for plans purchased on the Health Insurance Marketplace / Connect for Health Colorado benefits patients and physicians

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Reminder: Back pain guide program, effective July 19, 2021

July 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jul 1, 2021

Coordination of Care

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Important Information about Utilization Management

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Members’ Rights and Responsibilities

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Clinical Practice and Preventive Health Guidelines available on the web

December 2018 Anthem Provider Newsletter - CO Products & Programs Dec 1, 2018

Reminder: Updated AIM rehabilitative program, effective August 1, 2021 – and site of service reviews

July 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Jul 1, 2021

Blue High-Performance network name changing for 2022

November 2021 Anthem Provider News and Important Updates - Colorado Products & Programs Nov 1, 2021

Anthem fights opioid addiction: Extension for Community Healthcare Outcomes and Quality Medication-Assisted Therapy

October 2018 Anthem Provider Newsletter - CO Products & Programs Oct 1, 2018

Pharmacy information available at anthem.com

April 2019 Anthem Provider Newsletter - Colorado Pharmacy Apr 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

Drug fee schedule update

January 2022 Anthem Provider News and Important Updates - Colorado Pharmacy Jan 1, 2022

Pharmacy information available on anthem.com

June 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Jun 1, 2021

Clinical criteria updates for specialty pharmacy

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

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)

June 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Jun 1, 2021

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
July 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Jul 1, 2021

Pharmacy information available on anthem.com

October 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Oct 1, 2021

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News and Important Updates - Colorado Pharmacy May 1, 2021

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

Prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
May 2022 Anthem Provider News and Update - Colorado Pharmacy May 1, 2022

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

Anthem expands specialty pharmacy clinically equivalent drug list

October 2018 Anthem Important Updates - CO Pharmacy Oct 1, 2018

Anthem expands specialty pharmacy pre-certification list

October 2018 Anthem Important Updates - CO Pharmacy Oct 1, 2018

Anthem expands specialty pharmacy level of care (clinical site of care) drug list

October 2018 Anthem Important Updates - CO Pharmacy Oct 1, 2018

Anthem expands specialty pharmacy prior authorization list

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

Specialty dose rounding program for certain oncology medications

August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Anthem Blue Cross and Blue Shield to update formulary lists for commercial health plan pharmacy benefit

August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Immune globulin adjusted body weight dosting program beginning August 1, 2021

August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Pharmacy information available on anthem.com

August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2021 Anthem Provider News and Important Updates - Colorado Pharmacy Aug 1, 2021

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Feb 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Aug 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

Pharmacy information available on anthem.com

April 2022 Anthem Provider News and Important Updates - Colorado Pharmacy Apr 1, 2022

Anthem Announces Early Launch of IngenioRx

Anthem Announces Early Launch of IngenioRx Pharmacy Jan 30, 2019

Updated Coverage for HIV PrEP medications

July 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Jul 1, 2020

Reminder on Botox® for Anthem Blue Cross and Blue Shield members

April 2022 Anthem Provider News and Important Updates - Colorado Pharmacy Apr 1, 2022

Drug fee schedule update

April 2022 Anthem Provider News and Important Updates - Colorado Pharmacy Apr 1, 2022

Prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
April 2022 Anthem Provider News and Important Updates - Colorado Pharmacy Apr 1, 2022

Pharmacy information available at anthem.com

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

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
December 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Dec 1, 2020

AIM IVR changes for non-oncology medical specialty drug reviews effective on January 1, 2021

December 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Dec 1, 2020

Pharmacy information available on anthem.com

December 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Dec 1, 2020

Pharmacy information available on anthem.com

December 2019 Anthem Provider News and Important Updates - Colorado Pharmacy Dec 1, 2019

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Nov 1, 2020

IngenioRx Introduces New Pharmacy Network in 2021

November 2020 Anthem Provider News and Important Updates -- Colorado Pharmacy Nov 1, 2020

Specialty pharmacy updates

Material Adverse Change (MAC)
January 2023 Anthem Provider News - Colorado Pharmacy Dec 30, 2022

Anthem expands specialty pharmacy pre-certification list

August 2018 Anthem Important Updates - CO Pharmacy Aug 17, 2018

Anthem expands Specialty Pharmacy Clinical Site of Care (Level of Care) drug list

August 2018 Anthem Important Updates - CO Pharmacy Aug 17, 2018

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Colorado Pharmacy Apr 1, 2021
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