Indiana
Provider Communications

January 2021 Anthem Provider News - Indiana

Title	Category
Notice of Changes to Prior Authorization Requirements - January 2021 New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.	Administrative
IngenioRx introduces new pharmacy network in 2021	Pharmacy
Designated specialty pharmacy network*	Pharmacy
Prior authorization updates for specialty pharmacy are available - January 2021*	Pharmacy
Attention Workers’ Compensation network providers	Administrative
Join the Anthem Foundation and Dare to Care Hunger Challenge in Kentuckiana	Administrative
It is almost CAHPS survey time!	Administrative
Evaluation and management changes 2021	Administrative
New Blue HPN® plans go live January 1, 2021	Administrative
Outpatient system updates for 2021 - Facility	Administrative
Professional system updates for 2021	Administrative
New features added to Interactive Care Reviewer	Administrative
Procedure searches in Find Care: New sort option	Administrative
Availity attachment tools for Anthem and affiliate payers - Live webinars	Administrative
Self-service, digital transactions are fast and easy	Administrative
Medical Policy and Clinical Guideline Updates - January 2021*	Medical Policy & Clinical Guidelines
MCG Care Guidelines 24th Edition Customization*	Medical Policy & Clinical Guidelines
Anthem implements pilot program for in-network skilled nursing facilities (SNF)	Medical Policy & Clinical Guidelines
Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*	Reimbursement Policies
Reimbursement policy update: Frequency editing - Professional*	Reimbursement Policies
Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*	Reimbursement Policies
Reimbursement policy update: Modifier Rules - Professional*	Reimbursement Policies
Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*	Reimbursement Policies
2021 FEP® benefit information available online	Federal Employee Plan (FEP)
Medicaid News - January 2021 View these Medicaid articles: - New specialty pharmacy medical step therapy requirements - Policy Update: Nurse Practitioner and Physician Assistant Services - Prepayment coding validation review process	Medicaid
CAHPS education for providers	Medicaid
Notifications on the Availity portal	Medicaid
New specialty pharmacy medical step therapy requirements	Medicaid
Resources to support your pregnant and postpartum patients and their families	Medicaid
FDA approvals and expedited pathways used - new molecular entities (NMEs)	Medicaid
Sign up to receive email from Anthem Blue Cross and Blue Shield	Medicaid
Keep up with Medicare news - January 2021 View these Medicare articles: - Medicare Advantage Group Retiree Quick Reference Guide and FAQ - Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ - SNF admission reporting requirements for D-SNP plans - Policy Update: Nurse Practitioner and Physician Assistant Services – Professional - Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology	Medicare
Roman Catholic Diocese of Gary - Medicare Advantage option	Medicare
2020 Medicare risk adjustment provider trainings	Medicare
Updates to AIM clinical appropriateness guidelines for Advanced Imaging	Medicare
Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines	Medicare
Medical drug benefit clinical criteria updates	Medicare

Page 1 of 1

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem websites constitutes your agreement with our Terms of Use.

IndianaProvider Communications

January 2021 Anthem Provider News - Indiana

Indiana
Provider Communications