Connecticut
Provider Communications

July 2019 Anthem Connecticut Provider News

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Title Category

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Products & Programs

Update to provider/facility UM reimbursement penalties and corresponding update to Provider/Facility Manual

Administrative

Un-adopted clinical guidelines effective June 1, 2019

Medical Policy & Clinical Guidelines

State-supplied vaccines reminder - professional

Administrative

Sepsis diagnosis coding and billing reminder

Medicare

Payment recovery process simplified for National Accounts membership

Administrative

Outpatient Rehabilitation Program transitioning to AIM

Medicare

Modifier 79 reminder - professional

Administrative

Modifier 63 reminder - professional

Administrative

Make the move to the Availity EDI Gateway today

Administrative

Keep up with Medicare news

Medicare

ICD-10-CM coding guidelines and laterality - professional

Administrative

Home health billing guidelines for contracted providers

Medicare

Federal Employee Health Benefit Program® (FEP) PPO members will now require prior approval for specific specialty drugs and site of care

Federal Employee Plan (FEP)

Electronic claim payment reconsideration

Medicare

Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression

Administrative

Clinical validation - professional

Administrative

Clinical criteria updates for specialty pharmacy

Pharmacy

Clinical criteria coding updates for specialty pharmacy

Pharmacy
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