Indiana
Provider Communications

November 2019 Anthem Provider News - Indiana

Download as PDF

Title Category

Notice of Changes to Prior Authorization Requirements -- November 2019

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

Additional improvements coming to anthem.com

Administrative

Attention Workers’ Compensation Network Providers

Administrative

Indiana legislation requires providers to submit prior authorization requests electronically

Administrative

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

Products & Programs

Anthem clinical criteria and prior authorization updates for specialty pharmacy are available*

Pharmacy

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Medical Policy and Clinical Guidelines Updates -- November 2019*

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Medicare News -- November 2019

Medicare

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

Medicare

CMS reminder: expedited/urgent requests

Medicare

June 2019 Medical Policies and Clinical Utilization Management Guidelines Update

Medicare

Medicare Preferred PPO plan available to Retired Indiana Public Employees Insurance Trust retirees

Medicare

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicare

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Medicaid

Medical drug Clinical Criteria updates

Medicaid

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicaid
Page 1 of 1