CommercialJuly 1, 2020

July 2020 Anthem Provider News - Indiana

Administrative

AdministrativeCommercialJuly 1, 2020

Notice of Changes to Prior Authorization Requirements - July 2020
New prior authorization requirements for providers may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.

AdministrativeCommercialJuly 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

AdministrativeCommercialJuly 1, 2020

Welcome to the Custom Learning Center in Availity

AdministrativeCommercialJuly 1, 2020

Q-HIP update to Indiana facilities

AdministrativeCommercialJuly 1, 2020

Important change to prior authorization requests for inpatient hospital admissions*

Policy Updates

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2020

New MCG 24th Edition Guidelines

Products & Programs

Products & ProgramsCommercialJuly 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

Federal Employee Program (FEP)CommercialJuly 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

PharmacyCommercialJuly 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - July 2020*

PharmacyCommercialJuly 1, 2020

Updated coverage for HIV PrEP medications

State & Federal

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Medicaid News - July 2020
View these Medicaid articles:
- Modifier use reminders
- MCG care guidelines – 24th edition
- 2020 affirmative statement concerning utilization management decisions

State & FederalMedicare AdvantageJuly 1, 2020

2020 Special Needs Plans

State & FederalMedicare AdvantageJuly 1, 2020

In-Office Assessment Program

State & FederalMedicare AdvantageJuly 1, 2020

Medical drug benefit clinical criteria updates

State & FederalMedicare AdvantageJuly 1, 2020

2020 affirmative statement concerning utilization management decisions

State & FederalMedicare AdvantageJuly 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

State & FederalMedicare AdvantageJuly 1, 2020

Medicare News - July 2020
View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Member rights’ and responsibilities statement

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Important information about utilization management

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Complex case management program

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Coding spotlight: Provider’s guide to code social determinants of health

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2020

Prior authorization requirements for angiographic evaluation of stenotic or thrombosed dialysis circuits