CommercialDecember 1, 2018
December 2018 BCBSGa Provider Newsletter
Administrative
CommercialNovember 30, 2018
Coordination of Benefits for an FEP® memberCommercialNovember 30, 2018
2019 BCBSGa provider Town Hall meeting scheduleCommercialNovember 30, 2018
Availity to serve as EDI entry point for electronic submissionsCommercialNovember 30, 2018
Company works to simplify payment recovery process for National Accounts membershipCommercialNovember 30, 2018
Request an appeal using Interactive Care Reviewer (ICR)CommercialNovember 30, 2018
Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physiciansCommercialNovember 30, 2018
Coordination of careCommercialNovember 30, 2018
Important information about utilization managementCommercialNovember 30, 2018
Members’ rights and responsibilitiesCommercialNovember 30, 2018
Vaginal Birth after Cesarean (VBAC) certified shared decision making aid available on the webCommercialNovember 30, 2018
Clinical practice and preventive health guidelines available on anthem.comCommercialNovember 30, 2018
About our Network eUPDATE email toolCommercialNovember 30, 2018
2019 FEP Benefit information available onlineCommercialNovember 30, 2018
HEDIS® 2018 commercial results are inCommercialNovember 30, 2018
Use the Provider Maintenance Form to update your practice informationCommercialNovember 30, 2018
Clinical Practice and Preventive Health guidelines available on the webPolicy Updates
CommercialNovember 30, 2018
Notification of preapproval list changes (December 2018)CommercialNovember 30, 2018
System updates for 2019 (Professional)CommercialNovember 30, 2018
Coding tip: Claims processed with modifier 79 should be reported by the same health care professionalCommercialNovember 30, 2018
“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services (Professional)CommercialNovember 30, 2018
Updates to AIM musculoskeletal surgery clinical appropriateness guidelinesCommercialNovember 30, 2018
Update to AIM clinical appropriateness guidelinesCommercialNovember 30, 2018
Restructure of AIM advanced imaging clinical appropriateness guidelinesCommercialNovember 30, 2018
Anthem Blue Cross and Blue Shield Georgia Medical Policy and Clinical Guideline Updates 12/1/2018CommercialNovember 30, 2018
Bundled services and supplies (Professional)CommercialNovember 30, 2018
Reimbursement for convenience surgical supply kits (Professional)CommercialNovember 30, 2018
Scope of License reimbursement policy update (Professional)Products & Programs
CommercialNovember 30, 2018
Introducing SmartShopper, the consumer shopping and savings program for medical careCommercialNovember 30, 2018
Case Management ProgramCommercialNovember 30, 2018
ConditionCare Program benefits patients and physiciansCommercialNovember 30, 2018
Pharmacy information available on anthem.comCommercialNovember 30, 2018
BCBSGa accepts electronic prior authorization requests for prescription medications onlineCommercialNovember 30, 2018
Benefit change for Infliximab for Federal Employee ProgramCommercialNovember 30, 2018
Introducing the new Clinical Criteria page for injectable, infused or implanted drugsState & Federal
Medicare AdvantageNovember 30, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019Medicare AdvantageNovember 30, 2018
2019 Medicare Advantage individual benefits and formulariesMedicare AdvantageNovember 30, 2018
CMS Medicare Preclusion List effective April 1, 2019Medicare AdvantageNovember 30, 2018
When and how to initiate Medicare Advantage reopeningsMedicare AdvantageNovember 30, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Medical Policies updatedMedicare AdvantageNovember 30, 2018
Keep up with Medicare newsTo view this publication online:
Visit https://providernews.anthem.com/georgia/publications/december-2018-bcbsga-provider-newsletter-91
Or scan this QR code with your phone