Indiana
Provider Communications

Provider Spotlight

Aug 10, 2020

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.

Aug 1, 2020

Notice of changes to prior authorization requirements - August 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
- Anthem prior authorization updates for specialty pharmacy are available-August 2020*
- Medical Policy and Clinical Guideline Updates-August 2020*
- Expansion of AIM Musculoskeletal Program effective November 1, 2020*
- Reimbursement Policy Update: Claims requiring additional documentation (Facility)*


Articles Recent

Title Publication Category Date

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.
COVID-19 Information - Indiana Administrative Aug 10, 2020

Notice of changes to prior authorization requirements - August 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
- Anthem prior authorization updates for specialty pharmacy are available-August 2020*
- Medical Policy and Clinical Guideline Updates-August 2020*
- Expansion of AIM Musculoskeletal Program effective November 1, 2020*
- Reimbursement Policy Update: Claims requiring additional documentation (Facility)*
August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News - Indiana Pharmacy Aug 1, 2020

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

August 2020 Anthem Provider News - Indiana Pharmacy Aug 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - August 2020*

August 2020 Anthem Provider News - Indiana Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News - Indiana Pharmacy Aug 1, 2020

Provider contract and fee schedule notifications coming soon

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Evaluation and management services correct coding (Professional)

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Migrate your EDI transactions to Availity today

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Electronic claims submission - Clinical Laboratory Improvement Amendments (CLIA)

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Anthem electronic attachments - X12 275 5010

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Medical record standards

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Anthem Provider News - Indiana Administrative Aug 1, 2020

Medical policy and clinical guideline updates - August 2020*

August 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Aug 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020*

August 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

August 2020 Anthem Provider News - Indiana Reimbursement Policies Aug 1, 2020

Medicaid News - August 2020

View these Medicaid articles:
- Separately reimbursable DME when implanted in an outpatient setting – billing reminder
- Mid-level behavioral health and substance use providers may not bill evaluation and management services codes
August 2020 Anthem Provider News - Indiana Medicaid Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Indiana Medicaid Aug 1, 2020

Follow-up after hospitalization for mental illness

August 2020 Anthem Provider News - Indiana Medicaid Aug 1, 2020

Coding spotlight: Provider guide to coding for cardiovascular conditions

August 2020 Anthem Provider News - Indiana Medicaid Aug 1, 2020

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Indiana Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Indiana Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News - Indiana Medicare Aug 1, 2020

Notice of Changes to Prior Authorization Requirements - July 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
July 2020 Anthem Provider News - Indiana Administrative Jul 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Indiana Products & Programs Jul 1, 2020

Updated coverage for HIV PrEP medications

July 2020 Anthem Provider News - Indiana Pharmacy Jul 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - July 2020*

July 2020 Anthem Provider News - Indiana Pharmacy Jul 1, 2020

Important change to prior authorization requests for inpatient hospital admissions*

July 2020 Anthem Provider News - Indiana Administrative Jul 1, 2020

Q-HIP update to Indiana facilities

July 2020 Anthem Provider News - Indiana Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News - Indiana Administrative Jul 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

July 2020 Anthem Provider News - Indiana Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Jul 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

July 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Jul 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News - Indiana Federal Employee Plan (FEP) Jul 1, 2020

Medicaid News - July 2020

View these Medicaid articles:
- Modifier use reminders
- MCG care guidelines – 24th edition
- 2020 affirmative statement concerning utilization management decisions
July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Prior authorization requirements for angiographic evaluation of stenotic or thrombosed dialysis circuits

July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to code social determinants of health

July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Complex case management program

July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Important information about utilization management

July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Member rights’ and responsibilities statement

July 2020 Anthem Provider News - Indiana Medicaid Jul 1, 2020

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

2020 affirmative statement concerning utilization management decisions

July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

In-Office Assessment Program

July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News - Indiana Medicare Jul 1, 2020

Webinar recording now available for providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Indiana Behavioral Health Jun 25, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated June 9, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Indiana Administrative Jun 9, 2020

Notice of Changes to Prior Authorization Requirements - June 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
COVID-19 Information - Indiana Administrative Jun 1, 2020

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News - Indiana Products & Programs Jun 1, 2020

Anthem enhances process for submitting behavioral health authorizations - now available

June 2020 Anthem Provider News - Indiana Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News - Indiana Behavioral Health Jun 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - June 2020*

June 2020 Anthem Provider News - Indiana Pharmacy Jun 1, 2020

Reminder: Anthem requires National Drug Code for professional and facility outpatient claims effective June 15, 2020*

June 2020 Anthem Provider News - Indiana Pharmacy Jun 1, 2020

Pharmacy information available at anthem.com

June 2020 Anthem Provider News - Indiana Pharmacy Jun 1, 2020

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

Updated Provider Manual posted to anthem.com

June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

Quality Corner: CPT® Category II Codes - Collaborating for enhanced patient care

June 2020 Anthem Provider News - Indiana Administrative Jun 1, 2020

Medical Policy and Clinical Guideline Updates - June 2020*

June 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Jun 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines*

June 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Jun 1, 2020

REMINDER: AIM Rehabilitative Program Pediatric Exclusions

June 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines Jun 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)*

June 2020 Anthem Provider News - Indiana Reimbursement Policies Jun 1, 2020

Resources supporting our providers during COVID-19

June 2020 Anthem Provider News - Indiana Medicaid Jun 1, 2020

Acquisition of Beacon Health Options

June 2020 Anthem Provider News - Indiana Medicaid Jun 1, 2020

Reminder: Mid-level practitioners NPI reporting requirements

June 2020 Anthem Provider News - Indiana Medicaid Jun 1, 2020

HPV Vaccinations for Adolescents

June 2020 Anthem Provider News - Indiana Medicaid Jun 1, 2020

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Indiana Medicare Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (Updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Indiana Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Indiana Administrative May 29, 2020

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Indiana Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Indiana Administrative May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - May 2020*

May 2020 Anthem Provider News - Indiana Pharmacy May 1, 2020

COVID-19 information repository for Anthem Care Providers

May 2020 Anthem Provider News - Indiana Administrative May 1, 2020

Notice of Changes to Prior Authorization Requirements - May 2020

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
May 2020 Anthem Provider News - Indiana Administrative May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News - Indiana Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News - Indiana Administrative May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines*

May 2020 Anthem Provider News - Indiana Medical Policy & Clinical Guidelines May 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

May 2020 Anthem Provider News - Indiana Reimbursement Policies May 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Indiana Reimbursement Policies May 1, 2020

Normal newborn diagnosis-related group (DRG) claims processing update

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Medical drug benefit Clinical Criteria updates - December 2019

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Disease Management can help you care for patients with chronic health care needs

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Right Choices Program update

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Specialty pharmacy level of care

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020

Use of Imaging Studies for Low Back Pain (LBP)

May 2020 Anthem Provider News - Indiana Medicaid May 1, 2020
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