Maine
Provider Communications

Articles Recent

Title Publication Category Date

Notices of material changes/amendments to contract - December 2022

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Case management program

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Important information about utilization management

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Coordination of care

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Clinical Criteria updates for specialty pharmacy

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Pharmacy Dec 1, 2022

Specialty pharmacy updates - December 2022

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Pharmacy Dec 1, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

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

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Personal home helper benefit ending

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Member assessment of PCP after-hours messaging in 2022

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Member’s assessment of behavioral healthcare after-hours messaging in 2022

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Members’ rights and responsibilities

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

CAA: Timely updates help keep our provider directories current

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Clinical practice and preventive health guidelines available on anthem.com

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Signature requirements for laboratory orders or requisitions

December 2022 Provider Newsletter - Maine Administrative Dec 1, 2022

Pharmacy information available on the provider website

December 2022 Provider Newsletter - Maine Pharmacy Dec 1, 2022

Information from Anthem for Care Providers about COVID-19 (updated November 8, 2022)

COVID-19 Information - Maine Administrative Nov 8, 2022

PCP searches in Find Care

PCP searches in Find Care - Maine Administrative Nov 2, 2022

Notices of material changes/amendments to contract - November 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

  • Correction to reimbursement policy: Place of Service - Facility
  • Medical policy and clinical guideline updates available on anthem.com
  • Specialty pharmacy updates - November 2022
November 2022 Provider Newsletter - Maine Administrative Nov 1, 2022

Post office boxes being retired because of low usage

November 2022 Provider Newsletter - Maine Administrative Nov 1, 2022

Support documentation for AIM prior authorization requests

November 2022 Provider Newsletter - Maine Administrative Nov 1, 2022

CAA: Keep your provider directory information up to date

November 2022 Provider Newsletter - Maine Administrative Nov 1, 2022

Claims status message enhancements: providing clear descriptions and actionable next steps

November 2022 Provider Newsletter - Maine Digital Tools Nov 1, 2022

Authorization application enhancements: faster, easier, and more efficient

November 2022 Provider Newsletter - Maine Digital Tools Nov 1, 2022

Submit digital attachments within seven calendar days for claims filed with a PWK segment indicator

November 2022 Provider Newsletter - Maine Digital Tools Nov 1, 2022

You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too

November 2022 Provider Newsletter - Maine Digital Tools Nov 1, 2022

Visit the Provider Learning Hub to view our latest learning opportunities

November 2022 Provider Newsletter - Maine Digital Tools Nov 1, 2022

Correction to reimbursement policy: Place of Service - Facility

Notice of material change/amendment to contract
November 2022 Provider Newsletter - Maine Reimbursement Policies Nov 1, 2022

Medical policy and clinical guideline updates available on anthem.com

Notice of material change/amendment to contract

November 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Nov 1, 2022

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

November 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Nov 1, 2022

Specialty pharmacy updates - November 2022

Notice of material change/amendment to contract

November 2022 Provider Newsletter - Maine Pharmacy Nov 1, 2022

Remote EMR access service for HEDIS

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Personalized Match

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Register for our upcoming CME webinar about low back pain management

CME webinar about low back pain management - Maine Administrative Oct 7, 2022

Notices of material changes/amendments to contract - October 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:
  • Precertification list changes effective January 1, 2023
  • Clinical Criteria updates for specialty pharmacy
  • Specialty pharmacy updates - October 2022
  • Reimbursement policy update: Multiple and Bilateral Surgery Processing – Professional
October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Monkeypox and smallpox vaccines: Product code on claims

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Precertification list changes effective January 1, 2023

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

National Accounts 2023 Pre-certification list

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

CAA: Review your online provider directory information

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Provider Learning Hub is here

October 2022 Provider Newsletter – Maine Digital Tools Oct 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Clinical Criteria updates for specialty pharmacy

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Specialty pharmacy updates - October 2022

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Pharmacy information available on provider website

October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

October 2022 Provider Newsletter – Maine Federal Employee Plan (FEP) Oct 1, 2022

Monkeypox and smallpox vaccines: Product code on claims

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Keep up with Medicare news

  • Medicare Part B Precert Expansion Alymsys
  • Medicare Part B Precert Expansion Amvuttra Xipere
  • Consultation Codes
October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Continuing to Explore the Intersection of Race and Disability

Continuing to Explore the Intersection of Race and Disability forum - Maine Administrative Sep 9, 2022

Notices of material changes/amendments to contract - September 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

  • Reimbursement policy update:  Modifier Rules – Professional
  • Specialty pharmacy updates - September 2022
  • Clinical criteria updates for specialty pharmacy

 

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Anthem to accept Hospital in Home services

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Monkeypox resources and recommendations for our care providers

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Reimbursement policy update: Modifier Rules - Professional

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Specialty pharmacy updates - September 2022

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Reimbursement policy update - Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003)

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AMH Health LLC. expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Keep up with Medicare news    

  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
  • Clinical Criteria updates

 

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Continuing to Explore the Intersection of Race and Disability

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Important information about women’s preventive care visits

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Drug code billing reminder

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Updates to the Claim Attachment workflow

September 2022 Anthem Maine Provider News Digital Tools Sep 1, 2022

Update to formulary lists for Commercial health plan pharmacy benefit

September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

New Back Pain Management Program

September 2022 Anthem Maine Provider News Products & Programs Sep 1, 2022

Specialty pharmacy updates

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Notices of material changes/amendments to contract - August 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

  • Reimbursement policy update: Place of Service - Facility
  • Medical policy and clinical guideline updates are available on anthem.com
  • Specialty pharmacy updates
  • Clinical criteria updates for specialty pharmacy
August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Performance enhancements to the authorization application on Availity Essentials

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Reimbursement policy update: Place of Service - Facility

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Reimbursement Policies Aug 1, 2022

Medical policy and clinical guideline updates are available on anthem.com

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2022

Pharmacy information available on anthem.com

August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Reminder: Inpatient/outpatient commercial claim denials

August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Timely updates help keep our provider directories current

August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Introducing the Provider Learning Hub

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Add supporting documents directly to your claims with the new Claims Status Inquiry Send Attachments feature

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Telehealth visits can impact after-hospitalization follow-up care for mental illness

August 2022 Anthem Maine Provider News Behavioral Health Aug 1, 2022

Join us for our next clinical quality in practice webinar

Join us for our next clinical quality in practice webinar - Maine Administrative Jul 20, 2022

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

Notices of material changes/amendments to contract - July 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

  • Clinical criteria updates for specialty pharmacy
July 2022 Anthem Maine Provider News Administrative Jul 1, 2022
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