Indiana
Provider Communications

December 2022 Anthem Provider News - Indiana

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Title Category

CAA: Timely updates help keep our provider directories current

Administrative

Attention lab providers: COVID-19 update regarding reimbursement

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Member assessment of PCP after-hours messaging in 2022

Administrative

Members’ rights and responsibilities

Administrative

Member’s assessment of behavioral healthcare after-hours messaging in 2022

Administrative

Coordination of care

Administrative

Case management program

Administrative

Important information about utilization management

Administrative

IngenioRx will become CarelonRx on January 1, 2023

Administrative

Signature requirements for laboratory orders or requisitions

Administrative

For provider enrollment, please use the Digital Provider Enrollment tool in Availity, not the Provider Maintenance Form

Digital Tools

Pathway Essentials is expanding effective January 1, 2023

Products & Programs

Pharmacy information available on the provider website

Pharmacy

Specialty pharmacy updates - December 2022*

*Change to Prior Authorization Requirements
Pharmacy

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Medical Policies and Clinical Guidelines updates - December 2022*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Reimbursement policy update: Multiple Surgery - Facility

Reimbursement Policies

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Change to Prior Authorization Requirements

Reimbursement Policies

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

Reimbursement Policies

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Change to Prior Authorization Requirements

Reimbursement Policies

Keep up with Medicaid News - December 2022

- New specialty pharmacy medical step therapy requirements
- Prior Authorization Updates for Medications Billed Under the Medical Benefit (Saphnelo)
- New specialty pharmacy medical step therapy requirements (Mvasi, Avastin, Zirabev)
Medicaid

New Policy Diagnosis-Related Group Newborn Inpatient Stays - Facility

Medicaid

IngenioRx will become CarelonRx on January 1, 2023

Medicaid

Monkeypox and smallpox vaccines: Product code on claims

Medicaid

Keep up with Medicare News - December 2022

- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
Medicare

Personal home helper benefit ending

Medicare

2023 Medicare Advantage service area and benefit updates

Medicare
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