Indiana
Provider Communications

March 2023 Anthem Provider News - Indiana

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Title Category

Reminder - Updated Carelon Musculoskeletal Program effective April 1, 2023: monitored anesthesia care reviews

Administrative

AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.

Administrative

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

Administrative

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update*

*Change to Prior Authorization Requirements

Administrative

New policy for EMR clinical data sharing and ADT notifications*

*Change to Prior Authorization Requirements
Administrative

You are invited: Advancing Mental Health Equity for Youth & Young Adults

Register today for the Advancing Mental Health Equity for Youth & Young Adults forum hosted by Anthem Blue Cross and Blue Shield (Anthem) and Motivo* for Anthem providers on March 15, 2023.
Administrative

March is National Colorectal Cancer Awareness Month

Administrative

Engagement with your patient counts

Administrative

Physical and manipulative therapy for restoration versus maintenance

Administrative

Important reminder: Preventive care guidance for colonoscopy screening

Administrative

Reimbursement policy update: Modifiers 25 and 57 - Professional

Reimbursement Policies

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

Products & Programs

Specialty pharmacy updates for March 2023*

*Change to Prior Authorization Requirements

Pharmacy

Pharmacy information available on our provider website

Pharmacy

Keep up with Medicaid News - March 2023

- Medical Policies and Clinical Utilization Management Guidelines Update
- Prior authorization updates for medications billed under the medical benefit (Yusimry)
Medicaid

Complex Case Management program

Medicaid

Important information about utilization management

Medicaid

Keep up with Medicare News - March 2023

- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List for Indiana
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
Medicare

Annual planned visits

Medicare

Controlling High Blood Pressure and Submitting Compliant Readings

Medicare

Informational Update Modifier Usage

Medicare

Shared savings and transition care management after inpatient discharges

Medicare
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