Georgia
Provider Communications

September 2019 Anthem Provider News - Georgia

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Title Category

Reminder: Changes to timely filing requirements coming in October

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) audit happening now

Administrative

Anthem’s contract with Northeast Georgia Health System set to expire September 30, 2019 if no agreement is reached

Administrative

Access requirements for Behavioral Healthcare services

Administrative

Primary care provider after-hours access requirements

Administrative

Provider transparency update

Administrative

New app offers better digital health care support to members on September 1st

Administrative

Claim editing update for Excludes1 notes

Administrative

WellStar is out-of-network for Anthem Pathway members

Administrative

Coming soon: electronic attachments

Medicare

Clinical criteria updates

Medicare

Customizations to the 23rd edition of the MCG care guidelines

Medicare

Changes to prior authorization requirements

Medicare

Pharmacy benefit manager change to IngenioRx

Medicare

Keep up with Medicare news

Medicare

Clinical criteria and prior authorization updates for specialty pharmacy are available

Pharmacy

Anthem’s Georgia preapproval list change notification 9/1/2019

Policy Updates

New reimbursement policy: Maternity Services and Multiple Delivery (Professional)

Reimbursement Policies

New reimbursement policy: Intensity Modulated Radiation Therapy Planning and Delivery (Professional)

Reimbursement Policies

Reimbursement policy update: claims requiring additional documentation (Facility)

Reimbursement Policies
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