Colorado
Provider Communications

Articles

Title Publication Category Date

Readmission (Facility Reimbursement Policy - Update)

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

Provider Transparency Update

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

Provider Transparency Update

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

Provider Transparency Update

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Provider and Facility Manual update effective February 1, 2019 - CO

Provider and Facility Manual update effective February 1, 2019 - CO Administrative Dec 28, 2018

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

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

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

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

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

February 2019 Anthem Provider Newsletter - CO Administrative Feb 1, 2019

Provider Action Needed: verify your information is correct, and update us with any changes utilizing our online Provider Maintenance Form

November 2019 Anthem Provider News and Important Updates - Colorado Administrative Nov 1, 2019

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

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

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

December 2018 Anthem Important Updates - CO Reimbursement Policies Dec 1, 2018

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

February 2019 Anthem Important Updates - CO Reimbursement Policies Feb 1, 2019

Prior authorization requirements changes effective November 1, 2019

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

Prior authorization requirements changes effective November 1, 2019

November 2019 Anthem Provider News and Important Updates - Colorado Medicare Nov 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

Pre-Service/Prior Authorization Clinical Review Update -- February 2020 (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Feb 1, 2020

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

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

Postponed -- Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News and Important Updates - Colorado Medicare Jan 1, 2020

Please evaluate statin use for Medicare Advantage members with diabetes, cardiovascular disease

November 2018 Anthem Provider Newsletter - CO Medicare Nov 1, 2018

Plans offered in 2019

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

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

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

August 2018 Anthem Provider Newsletter - CO Pharmacy Aug 17, 2018

Pharmacy information available on anthem.com

February 2019 Anthem Provider Newsletter - CO Pharmacy Feb 1, 2019

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - CO Pharmacy Dec 1, 2018

Pharmacy information available on anthem.com

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

Pharmacy information available on anthem.com

October 2018 Anthem Provider Newsletter - CO Pharmacy Oct 1, 2018

Pharmacy information available at anthem.com

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

Pharmacy information available at anthem.com

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

Pharmacy information available at anthem.com

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

Pharmacy benefit manager change to IngenioRx

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

PCP after-hours access requirements

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

Partial hospitalization services

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

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

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

Outpatient Rehabilitation Program transitioning to AIM

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

Outpatient facility edit implementation effective April 26, 2020 (MAC)

Material Adverse Change (MAC)
January 2020 Anthem Provider News and Important Updates - Colorado Reimbursement Policies Jan 1, 2020

Options for helping members avoid ER visits during flu season

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

Once per Lifetime Procedures – Professional

August 2018 Anthem Provider Newsletter - CO Reimbursement Policies Aug 17, 2018

Now Available: Get patient payments faster with Healthcare Bill Payments at anthem.com

September 2018 Anthem Provider Newsletter - CO Administrative Aug 31, 2018

Non-participating lab referrals

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

Non-participating lab referrals

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

Non-participating lab referrals

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

Non-participating lab referrals

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Non-participating lab referrals

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

New Year brings new ID cards for many Anthem members

January 2020 Anthem Provider News and Important Updates - Colorado Administrative Jan 1, 2020

New Year Brings New ID Cards - and New ID Numbers - for Many Anthem Members

January 2019 New Year Brings New ID Cards and New ID Numbers for Many Anthem Members - CO Administrative Jan 25, 2019

New specialty Medicare Part B device preferred product program

February 2019 Anthem Provider Newsletter - CO Medicare Feb 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

New Reimbursement Policies (Professional): Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers

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

New process to submit claim payment disputes electronically

October 2018 Anthem Provider Newsletter - CO Administrative Oct 1, 2018

New pre-certification requirement for EGD services begins November 1, 2018

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

New Pathway PPO network to support new product offerings available January 1, 2020

January 2020 Anthem Provider News and Important Updates - Colorado Administrative Jan 1, 2020

New Musculoskeletal and Pain Management Solution Effective for Select National ASO Accounts January 1, 2020

January 2020 Anthem Provider News and Important Updates - Colorado Administrative Jan 1, 2020

New Medicare Advantage provider service phone number beginning January 1, 2019

December 2018 Anthem Provider Newsletter - CO Medicare Dec 1, 2018

New look to our Medical Attachment submission tool

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

New ICR Immediate Decision List posted on Availity Payer Spaces

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

New enhancements to the Interactive Care Reviewer (ICR) tool

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

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

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

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

New Autism Codes Effective January 1, 2019 - CO

New Autism Codes Effective January 1, 2019 - CO Administrative Dec 12, 2018

New AIM Rehabilitation program effective July 1, 2019

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

New 2019 Health Care Plan information for all Colorado PERA Retirees UPDATED - CO

New 2019 Health Care Plan information for all Colorado PERA Retirees UPDATED - CO Administrative Jan 25, 2019

New 2019 Health Care Plan information for all Colorado PERA Retirees - CO

New 2019 Health Care Plan information for all Colorado PERA Retirees - CO Medicare Oct 3, 2018

Networks at a Glance

December 2018 Anthem Provider Newsletter - CO Administrative Dec 1, 2018

Network Update newsletter has a new look and usability features

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

National Drug Code (NDC) Requirement on Outpatient Claims expanded - effective May 1, 2019

February 2019 Anthem Important Updates - CO Administrative Feb 1, 2019

National Accounts 2020 Pre-certification list

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

MyDiversePatients.com addresses health care disparities

September 2018 Anthem Provider Newsletter - CO Medicare Aug 31, 2018

Modifier 79 reminder: Professional

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

Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period - Professional

December 2018 Anthem Provider Newsletter - CO Reimbursement Policies Dec 1, 2018

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

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

Modifier 63 reminder: Professional

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

Members’ Rights and Responsibilities

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

Members’ Rights and Responsibilities

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

Member Satisfaction with Behavioral Health Outpatient Services

February 2019 Anthem Provider Newsletter - CO Behavioral Health Feb 1, 2019

Member Explanation of Benefits gets a makeover

August 2018 Anthem Provider Newsletter - CO Administrative Aug 17, 2018

Medicare preferred continuous glucose monitors

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

Medicare pharmacy and prescriber home starts January 2019

October 2018 Anthem Provider Newsletter - CO Medicare Oct 1, 2018

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

December 2018 Anthem Provider Newsletter - CO Medicare Dec 1, 2018

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Provider Newsletter - CO Medicare Jan 1, 2019

Medical records request for risk adjustment

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

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

August 2018 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Aug 17, 2018

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

November 2018 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Nov 1, 2018

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

September 2018 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Aug 31, 2018

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates -- Colorado Medical Policy & Clinical Guidelines Feb 1, 2020

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

Medical Policy and Clinical UM Guidelines notification letter

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

Medical Policy and Clinical UM Guidelines notification (MAC)

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

Medical Policy and Clinical UM Guidelines change notification letter

February 2019 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Feb 1, 2019

Medical Policy and Clinical UM Guideline changes notification letter

March 2019 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Mar 1, 2019

Medical Policy and Clinical UM Guideline changes notification letter

January 2019 Anthem Important Updates - CO Medical Policy & Clinical Guidelines Jan 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

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

Medical drug Clinical Criteria updates

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

Medical drug benefit Clinical Criteria updates – October 2019

January 2020 Anthem Provider News and Important Updates - Colorado Medicare Jan 1, 2020

Medical drug benefit Clinical Criteria updates – November 2019

January 2020 Anthem Provider News and Important Updates - Colorado Medicare Jan 1, 2020
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