Georgia
Provider Communications

September 2020 Anthem Provider News - Georgia

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Title Category

Site of care* medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020

Products & Programs

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

Products & Programs

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Updates for specialty pharmacy are available (September 2020)

Pharmacy

Providers can now receive and respond to medical record requests for postpay audit via Change Healthcare’s Assurance Attach Assist Module

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program Continues

Administrative

New provider directory indicators for medication assisted treatment (MAT) providers

Administrative

EDI Gateway migration deadline is September 15, 2020

Administrative

Enhanced medical records submission process to support claims processing

Administrative

Patient360 adds Care Gap Alert Feedback for medical providers

Administrative

Anthem Georgia preapproval list change notification 9/1/2020

Policy Updates

Reimbursement policy update: Distinct Procedural Services Modifiers 59, XE, XP, XS, XU (Professional)

Reimbursement Policies

Reimbursement policy update: Frequency Editing (Professional)

Reimbursement Policies

Medical drug benefit Clinical Criteria updates

Medicare

Update: Notice of changes to the AIM musculoskeletal program

Medicare

Keep up with Medicare news

Medicare
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