November 1, 2019

November 2019 Anthem Provider News - Kentucky

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Administrative

AdministrativeCommercialNovember 1, 2019

Additional improvements coming to anthem.com

AdministrativeCommercialOctober 15, 2019

Attention Workers’ Compensation Network Providers

AdministrativeCommercialNovember 1, 2019

Appropriate coding helps provide a comprehensive picture of patients’ health

Policy Updates

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2019

Medical Policy and Clinical Guidelines Updates -- November 2019

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2019

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

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2019

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Products & Programs

Products & ProgramsCommercialNovember 1, 2019

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

PharmacyCommercialNovember 1, 2019

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

PharmacyCommercialNovember 1, 2019

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

State & Federal

State & FederalMedicare AdvantageNovember 1, 2019

Medicare News -- November 2019

State & FederalMedicare AdvantageNovember 1, 2019

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

State & FederalMedicare AdvantageNovember 1, 2019

CMS reminder: expedited/urgent requests

State & FederalMedicare AdvantageNovember 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

State & FederalMedicaidNovember 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines Update

State & FederalMedicaidNovember 1, 2019

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

State & FederalMedicaidNovember 1, 2019

Medical Drug Clinical Criteria updates

State & FederalMedicaidNovember 1, 2019

Prior authorization requirements changes effective November 1, 2019

State & FederalMedicaidNovember 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization