CommercialSeptember 1, 2019

September 2019 Anthem Provider News - Indiana

Administrative

AdministrativeCommercialSeptember 1, 2019

Notice of Changes to Prior Authorization Requirements -- September 2019
New prior authorization requirement for providers and/or Material Changes to Contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.

AdministrativeCommercialSeptember 1, 2019

Reminder: Changes to timely filing requirements coming in October

AdministrativeCommercialSeptember 1, 2019

Provider Transparency Update

AdministrativeCommercialSeptember 1, 2019

Anthem launches Sydney on September 1; new app offers better digital health care support to members

AdministrativeCommercialSeptember 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

AdministrativeCommercialSeptember 1, 2019

Claims requiring additional documentation facility reimbursement policy update

AdministrativeCommercialSeptember 1, 2019

PCP after-hours access requirements

AdministrativeCommercialSeptember 1, 2019

Start using Anthem’s electronic portals now for prior authorization requests

Behavioral Health

Behavioral HealthCommercialSeptember 1, 2019

Access requirements for behavioral health care services

Policy Updates

Medical Policy & Clinical GuidelinesCommercialSeptember 1, 2019

Clinical Guideline Updates -- September 2019*

Reimbursement PoliciesCommercialSeptember 1, 2019

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

Reimbursement PoliciesCommercialSeptember 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

Reimbursement PoliciesCommercialSeptember 1, 2019

Claim editing update for Excludes1 notes

Products & Programs

PharmacyCommercialSeptember 1, 2019

Clinical criteria and prior authorization updates for specialty pharmacy are available*

State & Federal

State & FederalMedicare AdvantageSeptember 1, 2019

Medicare News -- September 2019

State & FederalMedicare AdvantageSeptember 1, 2019

Coming soon: Electronic attachments

State & FederalMedicare AdvantageSeptember 1, 2019

Clinical Criteria updates

State & FederalMedicare AdvantageSeptember 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

State & FederalMedicare AdvantageSeptember 1, 2019

Changes to prior authorization (PA) requirements

State & FederalMedicare AdvantageSeptember 1, 2019

Pharmacy benefit manager change to IngenioRx

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

Reimbursement Policy Update: Professional Anesthesia Services

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

AIM Specialty Health programs may require documentation

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

Coming soon: Electronic attachments

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

Prior authorization changes

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

Clinical Criteria updates

State & FederalHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2019

Prior authorization requirements for hyperbaric oxygen and supervision of hyperbaric oxygen therapy