CommercialDecember 1, 2022

December 2022 Anthem Provider News - Indiana

Administrative

AdministrativeCommercialDecember 1, 2022

CAA: Timely updates help keep our provider directories current

AdministrativeCommercialDecember 1, 2022

Attention lab providers: COVID-19 update regarding reimbursement

AdministrativeCommercialDecember 1, 2022

Member assessment of PCP after-hours messaging in 2022

AdministrativeCommercialDecember 1, 2022

Members’ rights and responsibilities

AdministrativeCommercialDecember 1, 2022

Coordination of care

AdministrativeCommercialDecember 1, 2022

Case management program

AdministrativeCommercialDecember 1, 2022

Important information about utilization management

AdministrativeCommercialDecember 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

AdministrativeCommercialDecember 1, 2022

Signature requirements for laboratory orders or requisitions

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*
*Change to Prior Authorization Requirements

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2022

Medical Policies and Clinical Guidelines updates - December 2022*
*Change to Prior Authorization Requirements

Reimbursement PoliciesCommercialDecember 1, 2022

Reimbursement policy update: Multiple Surgery - Facility

Reimbursement PoliciesCommercialDecember 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Change to Prior Authorization Requirements

Reimbursement PoliciesCommercialDecember 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Change to Prior Authorization Requirements

Products & Programs

Products & ProgramsCommercialDecember 1, 2022

Pathway Essentials is expanding effective January 1, 2023

PharmacyCommercialDecember 1, 2022

Pharmacy information available on the provider website

PharmacyCommercialDecember 1, 2022

Specialty pharmacy updates - December 2022*
*Change to Prior Authorization Requirements

State & Federal

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingDecember 1, 2022

Keep up with Medicaid News - December 2022
- New specialty pharmacy medical step therapy requirements
- Prior Authorization Updates for Medications Billed Under the Medical Benefit (Saphnelo)
- New specialty pharmacy medical step therapy requirements (Mvasi, Avastin, Zirabev)

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingDecember 1, 2022

New Policy Diagnosis-Related Group Newborn Inpatient Stays - Facility

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingDecember 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingDecember 1, 2022

Monkeypox and smallpox vaccines: Product code on claims

State & FederalMedicare AdvantageDecember 1, 2022

Keep up with Medicare News - December 2022
- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update

State & FederalMedicare AdvantageDecember 1, 2022

Personal home helper benefit ending

State & FederalMedicare AdvantageDecember 1, 2022

2023 Medicare Advantage service area and benefit updates