Indiana
Provider Communications

March 2021 Anthem Provider News - Indiana

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Title Category

Notice of Changes to Prior Authorization Requirements - March 2021

New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
Administrative

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021*

*Change to Prior Authorization Requirements
Pharmacy

Updates for specialty pharmacy are available - March 2021*

*Change to Prior Authorization Requirements
Pharmacy

Some HIV medication combinations may require prior authorization*

*Change to Prior Authorization Requirements
Pharmacy

Medical attachment capability now includes itemized bills and more!

Administrative

Update: Notice of changes to the AIM Small Joint Surgery guideline

Medical Policy & Clinical Guidelines

Anthem clarifies guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNFs)

Medical Policy & Clinical Guidelines

Claims editing update for ICD-10-CM Excludes 1 notes

Reimbursement Policies

New reimbursement policy update: Place of Service Evaluation and Management - Facility*

*Change to Prior Authorization Requirements
Reimbursement Policies

New Hoosier Care Connect contract starting April 2021

Medicaid

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards

Medicaid

Digital transactions cut administrative tasks in half

Medicaid

Neulasta medical step therapy requirements

Medicaid

Prior authorization requirements for HCPCS code 55899

Medicaid

Disease Management/Population Health program

Medicaid

CAHPS® survey

Medicaid

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

Medicaid

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
Medicare

New provider directory indicator for telehealth services

Medicare

Medical policies and clinical utilization management guidelines update

Medicare

Digital transactions cut administrative tasks in half

Medicare
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