CommercialMay 1, 2020

May 2020 Anthem Provider News - Indiana

Administrative

AdministrativeCommercialMay 1, 2020

COVID-19 information repository for Anthem Care Providers

AdministrativeCommercialMay 1, 2020

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

AdministrativeCommercialMay 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

AdministrativeCommercialMay 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

Medical Policy & Clinical GuidelinesCommercialMay 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

Medical Policy & Clinical GuidelinesCommercialMay 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline*

Medical Policy & Clinical GuidelinesCommercialMay 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines*

Reimbursement PoliciesCommercialMay 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

Reimbursement PoliciesCommercialMay 1, 2020

Reminder about system updates

Products & Programs

PharmacyCommercialMay 1, 2020

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

State & Federal

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

Normal newborn diagnosis-related group (DRG) claims processing update

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

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

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

Medical drug benefit Clinical Criteria updates - November 2019

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

Medical drug benefit Clinical Criteria updates - December 2019

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

Disease Management can help you care for patients with chronic health care needs

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

Right Choices Program update

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

Specialty pharmacy level of care

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

Use of Imaging Studies for Low Back Pain (LBP)

State & FederalMedicare AdvantageMay 1, 2020

Medicare News - May 2020
View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax

State & FederalMedicare AdvantageMay 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

State & FederalMedicare AdvantageMay 1, 2020

Multi-dose packaging