Kentucky
Provider Communications

February 2021 Anthem Provider News - Kentucky

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Title Category

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging

Medicare

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

Reimbursement Policies

Reimbursement policy update: Emergency Room Transfers - Facility

Reimbursement Policies

Prior authorization updates for specialty pharmacy are available - February 2021

Pharmacy

PN for UM AROW Item 1330

Medicare

Pharmacy information available at anthem.com

Pharmacy

New provider directory indicator for telehealth services

Administrative

New Anthem utilization management tool now available on Availity: Authorization Rules Lookup tool

Administrative

Medical Policy and Clinical Guideline Updates - February 2021

Medical Policy & Clinical Guidelines

Medical drug benefit clinical criteria updates - February 2021

Medicaid

Medical drug benefit clinical criteria updates - February 2021

Medicare

Medicaid News - February 2021

View these Medicaid articles:
- InterQual 2020.1 update
- New specialty pharmacy medical step therapy requirements-1
- New specialty pharmacy medical step therapy requirements-2
- Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging
- Sign up to receive email from Anthem Blue Cross and Blue Shield Medicaid
Medicaid

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

Medicaid

FDA approvals and expedited pathways used - new molecular entities (NMEs)

Medicaid

CAHPS® survey

Medicaid

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy
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