Kentucky
Provider Communications

November 2019 Anthem Provider News - Kentucky

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Title Category

Additional improvements coming to anthem.com

Administrative

Attention Workers’ Compensation Network Providers

Administrative

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

Products & Programs

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Anthem clinical criteria and prior authorization updates for specialty pharmacy are available

Pharmacy

Medical Policy and Clinical Guidelines Updates -- November 2019

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Medicare News -- November 2019

Medicare

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

Medicare

CMS reminder: expedited/urgent requests

Medicare

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicare

June 2019 Medical Policies and Clinical Utilization Management Guidelines Update

Medicaid

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Medicaid

Medical Drug Clinical Criteria updates

Medicaid

Prior authorization requirements changes effective November 1, 2019

Medicaid

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicaid
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