Highlights

Key Updates

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 1, 2024

Roster Automation updates: roster download functionality

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 23, 2024

Do you offer telehealth services? Let us know!


What's New

Recent Updates

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialNovember 21, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Maine 2025 Medicare Advantage plan changes

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 18, 2024

Notice of material change/amendment to contract

Specialty pharmacy updates — December 2024

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Notice of change: Part D Rx HCCs

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 18, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 15, 2024

Skilled nursing facility — vaccine serum compensation

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 14, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageNovember 1, 2024

Roster Automation updates: roster download functionality

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — November 2024

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Introducing a new Applied Behavior Analysis Provider Resource Guide

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Change in precertification penalty

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

High Performing and Blue National Designated Providers may also be known as Anthem Diamond Providers

Policy Updates Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Notice of material change/amendment to contract

Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — Professional

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Adopting digital member ID cards

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

New claims requirement: add-on codes must include primary procedure starting December 2024

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Notice of material change/amendment to contract

Precertification List Change Notification — November 1, 2024

Products & Programs Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Submit corrected claims electronically for the Federal Employee Program®

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Notice of material change/amendment to contract

Precertification List Change Notification — November 1, 2024

Codes J3393 and J3394

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

More error types for corrected claims submitted through EDI now available

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2024

Personalized Match update

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 30, 2024

Clinical Criteria updates

Effective December 2, 2024

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 29, 2024

HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 24, 2024

Notice of material change/amendment to contract

Specialty pharmacy updates — November 2024

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Quality Management Optimizing HEDIS & STARSAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 23, 2024

HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025

Quality Management Optimizing HEDIS & STARSAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 22, 2024

HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 16, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 16, 2024

Carelon Medical Benefits Management, Inc. updates

Effective November 17, 2024

Education & TrainingAMH Health, LLC | Medicare AdvantageOctober 15, 2024

Model of Care training reminder

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialOctober 8, 2024

HEDIS Measure Tips — Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) 2025

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 7, 2024

HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025

Quality Management Optimizing HEDIS & STARSAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 4, 2024

HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025

Quality Management Optimizing HEDIS & STARSAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 3, 2024

Blood Pressure Control for Patients With Diabetes (BPD) 2025

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 2, 2024

Pharmacotherapy Management of COPD Exacerbation (PCE) 2025

Policy Updates Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Reimbursement policy update: Modifier FB — Professional and Facility

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the HPP designation program for individual member (Exchange) commercial networks

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

National Accounts 2025 precertification list

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

HEDIS medical record submission made easier with our Remote EMR Access service

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Pharmacy information available on our provider website

Policy Updates Reimbursement PoliciesAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Now live: view your fee schedule in Availity Essentials Payer Spaces

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Prevent flu and COVID-19: drive the change through vaccination

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — October 2024

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Medical Policy and Clinical Guideline updates

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the Specialty High Performing Provider designation program for commercial networks

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025