Georgia
Provider Communications

August 2019 Anthem Provider News - Georgia

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Title Category

Provider Manuals on anthem.com

Administrative

Anthem customizations to MCG care guidelines 23rd edition

Administrative

Updates to AIM Advanced Imaging clinical appropriateness guidelines

Products & Programs

Updates to AIM Radiation Oncology: Proton Beam Therapy clinical appropriateness guideline

Products & Programs

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

Products & Programs

National Drug Code requirement on outpatient claims

Pharmacy

Clinical Criteria and prior authorization updates for specialty pharmacy are available

Pharmacy

Reminder: changes to the process for medical non-oncology specialty drug reviews effective June 15, 2019

Pharmacy

Pharmacy information available on the web

Pharmacy

Bundled Services reimbursement policy update (Professional)

Policy Updates

Frequency Editing reimbursement policy update (Professional)

Reimbursement Policies

Georgia medical policy and clinical guideline updates 8/1/2019

Medical Policy & Clinical Guidelines

Update to Emergency Department Level of E&M Services reimbursement policy

Medicare

New service types added to Availity

Medicare

Prepayment clinical validation review process

Medicare

New Drug Screen Testing reimbursement policy

Medicare

Unspecified diagnosis code update

Medicare

AIM Specialty Health programs may require documentation

Medicare

Provider training required for special needs plans

Medicare

Keep up with Medicare news

Medicare
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