State & FederalMedicare AdvantageApril 1, 2021

In-office assessment program

Welcome to the 2021 in-office assessment (IOA) program. The IOA program is designed to help providers ensure that all active conditions are continuously being addressed and documented to the highest level of specificity for all Medicare Advantage plan patients of providers participating in the program. This program is designed to help improve all patient quality of care (preventive medicine screening, managing chronic illness and prescription management), as well as care for older adults when generated for a special needs plan member.

 

If you are interested in learning about the electronic modalities available, please contact your representative or the Optum* provider support center at 877-751-9207, Monday through Friday, from 8:00 a.m. to 7:00 p.m. eastern time.

 

Success stories

Below are some achievements that Anthem Blue Cross and Blue Shield (Anthem) was able to accomplish with provider groups through the IOA program:

  • As a result of leveraging different types of resources offered by the IOA program (for example, technology), providers’ offices were able to see an increase in staff productivity.
  • Providers who have taken advantage of the IOA program resources have seen an increase in their documentation and coding accuracy.

 

COVID-19 update

Anthem knows this is a difficult time for everyone, as the situation continues to evolve each day. Anthem has considered the severity of the situation and is following CDC guidelines. For the IOA program, all nonessential personal are required to work with provider groups telephonically/electronically until further notice.

 

Anthem continues to evaluate the situation and guidelines, and will keep you notified of any changes. If you have any questions or concerns about the IOA program and COVID-19 updates, please call the Optum provider support center at 877-751-9207, Monday through Friday, from 8:00 a.m. to 7:00 p.m. eastern time.

 

Dates and tips to remember:

  • To review their population as soon as possible, Anthem strongly encourages participating providers to deliver and continually maintain proper care management, as well as care coordination of their patient population. This will further ensure the current and active conditions that impact patient care, treatment and/or management are continually addressed.
  • At the conclusion of each office visit with the patient, providers participating in the IOA program are asked to complete and return a patient assessment. The assessment should be completed based on information regarding the patient’s health collected during the office visit. Participating providers may continue to use the 2021 version of the assessment for encounters that take place on or before December 31, 2021; Anthem will accept the 2021 version of the assessment for 2021 encounters until midnight January 31, 2022.
  • If not already submitted, participating providers are required to submit an account setup form, W-9 and completed direct deposit enrollment by March 31, 2022. Participating providers should call the Optum provider support center at 877-751-9207, Monday through Friday, from 8:00 a.m. to 7:00 p.m. eastern time, if they have any questions regarding this requirement. Failure to comply with this requirement will result in forfeiture of the provider payment for submitted 2021 assessments, if applicable.

 

Questions

If you have questions about this communication or the IOA program, please contact your representative or the Optum provider support center at 877-751-9207, Monday through Friday, from 8:00 a.m. to 7:00 p.m. eastern time.

 

*Optum is an independent company providing care services on behalf of Anthem Blue Cross and Blue Shield. 


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