Indiana
Provider Communications

June 2021 Anthem Provider News - Indiana

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Title Category

Answering your claims questions is easier through chat; secure messaging will sunset soon, start using chat now

Administrative

Continuation of skilled nursing facility (SNF) process in Indiana and Ohio

Medical Policy & Clinical Guidelines

Designated specialty pharmacy network updates

Pharmacy

Designated specialty pharmacy network: Reminders and contact information

Pharmacy

DEXA bone scan criteria for the Federal Employee Program®

Federal Employee Plan (FEP)

Digital solution options with Availity

Digital Tools

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Digital Tools

Keep your contact information current

Administrative

Let’s vaccinate

Products & Programs

Medicaid News - June 2021

View these Medicaid articles:
- False Claims Act awareness
- MCG Care Guidelines 24th edition customization
- May 2020 medical policies and clinical utilization management guidelines update
- November 2020 medical policies and clinical utilization management guidelines update
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
Medicaid

Medical policies and clinical utilization management guidelines update

Medicare

Medical policy and clinical guideline updates - June 2021*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
Medicare

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

Medicaid

New Back Pain Management Program effective July 19, 2021

Medical Policy & Clinical Guidelines

Pharmacy information available at anthem.com

Pharmacy

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

Administrative

Prior authorization for genetic testing medical policy effective September 1, 2021*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Regular check-ins with your clearinghouse could affect timely filing

Administrative

Reimbursement policy reminder: Inpatient readmissions

Medicare

Reimbursement policy update: Outpatient facility claim edits

Reimbursement Policies

Reminder: Behavioral health midlevel providers may not bill E&M services codes

Medicaid

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

Medicare

Submit EDI corrected claims via Availity or EDI

Digital Tools

Two great learning resources on one secure portal

Digital Tools

Updates for specialty pharmacy are available - June 2021*

*Change to Prior Authorization Requirements
Pharmacy

Updates to AIM advanced imaging clinical appropriateness guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM musculoskeletal program clinical appropriateness guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines
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