Policy UpdatesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 21, 2023

Lab testing reminder

Background

Anthem Blue Cross and Blue Shield follows MCG Care Guidelines for the following lab tests.

You can view appropriate Clinical Utilization Management Guidelines (CUMGs) here.

Update

In compliance with MCG Care Guidelines, only medically necessary lab testing will be covered. Effective February 19, 2024, coverage for these labs will be denied unless medically necessary:

CUMG number/title

CG-LAB-24 – Urine Culture Testing

CG-LAB-25 – Glycated Hemo Protein (A1c) Testing

CG-LAB-26 – Outpatient Alpha-Fetoprotein Testing

What if I have questions?

Availity Chat with Payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. To access Availity Essentials, go to Availity.com and select the appropriate payer space tile from the drop-down. Then, select Chat with Payer and complete the pre-chat form to start your chat.

For additional support, visit the Contact Us section at the bottom of our provider's website for the appropriate contact.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan, and Hoosier Care Connect through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. This includes but is not limited to authorization, covered benefits and services, and claims submittal. If you have questions, please contact your group administrator or your Anthem network representative.

INBCBS-CD-037375-23-CPN36786

PUBLICATIONS: December 2023 Provider Newsletter