CommercialSeptember 1, 2020

September 2020 Anthem Provider News - Indiana

Administrative

AdministrativeCommercialSeptember 1, 2020

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

AdministrativeCommercialSeptember 1, 2020

New provider directory indicators for medication assisted treatment (MAT) providers

AdministrativeCommercialSeptember 1, 2020

Attention workers’ compensation network providers

AdministrativeCommercialSeptember 1, 2020

EDI Gateway migration deadline is September 15, 2020

AdministrativeCommercialSeptember 1, 2020

Providers can now receive and respond to medical record requests for post-pay audit via Change Healthcare’s Assurance Attach Assist Module

AdministrativeCommercialSeptember 1, 2020

Enhanced medical records submission process to support claims processing

AdministrativeCommercialSeptember 1, 2020

Patient360 adds care gap alert feedback for medical providers

AdministrativeCommercialSeptember 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program continues

Policy Updates

Reimbursement PoliciesCommercialSeptember 1, 2020

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

Reimbursement PoliciesCommercialSeptember 1, 2020

Reimbursement policy update: Frequency Editing (Professional)*

Products & Programs

Products & ProgramsCommercialSeptember 1, 2020

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020*

Products & ProgramsCommercialSeptember 1, 2020

Meet your Cancer Care Navigator
Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.

Products & ProgramsCommercialSeptember 1, 2020

Predictive analytics guide proactive support to patients undergoing chemotherapy resulting in lowered admissions

PharmacyCommercialSeptember 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

PharmacyCommercialSeptember 1, 2020

Specialty pharmacy updates are available - September 2020*

State & Federal

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

Medicaid News - September 2020
View these Medicaid article:
- Medical drug benefit clinical criteria updates
- Submit behavioral health authorizations via our online Interactive Care Reviewer tool

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

Medical policies and clinical utilization management guidelines update

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

Provider demographics update

State & FederalMedicare AdvantageSeptember 1, 2020

Update: Notice of changes to the AIM musculoskeletal program

State & FederalMedicare AdvantageSeptember 1, 2020

Medical drug benefit clinical criteria updates