Key Updates
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
2025 Clinical Quality in Practice webinar series
Recent Updates
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageFebruary 14, 2025
Clinical Criteria updatesEffective March 24, 2025
Anthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Developmental screening in the first three years of lifeAnthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Chlamydia Screening (CHL) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 10, 2025
Colorectal Cancer Screening (COL-E) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 4, 2025
Expansion of Carelon Medical Benefits Management, Inc. programsAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Corrected claim guidance for the Federal Employee Program®Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
New Communication Center added to Availity EssentialsAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Clinical Criteria updates for specialty pharmacyEffective May 1, 2025
Anthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Medical records needed for accurate payment of certain facility inpatient claimsAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Pharmacy information available on our provider websiteAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
2025 Clinical Quality in Practice webinar seriesAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — February 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and FacilityAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Avoidance of Antibiotics Treatment for Acute Bronchitis/Bronchiolitis (AAB)Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 28, 2025
Eye Exam for Patients with Diabetes (EED) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 27, 2025
Key formulary updates: effective January 1, 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 22, 2025
Breast Cancer Screening (BCS-E) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 22, 2025
Statin Therapy for Patients with Cardiovascular Disease (SPC) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 21, 2025
Eye Exam for Patients with Diabetes (EED) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 21, 2025
Controlling High Blood Pressure (CBP)Anthem Blue Cross and Blue Shield | CommercialJanuary 17, 2025
Adult Immunization Status (AIS‑E) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 16, 2025
Asthma Medication Ratio (AMR) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 16, 2025
Submitting authorization for NICU services facilitates accurate and timely claims processingAnthem Blue Cross and Blue Shield | CommercialJanuary 16, 2025
Kidney Health Evaluation for Patients With Diabetes (KED) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 14, 2025
Authorization for post‑acute care services for FEP membersAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 13, 2025
Statin Therapy for Patients with Cardiovascular Disease (SPC) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 13, 2025
Colorectal Cancer Screening (COL‑E) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 13, 2025
Kidney Health Evaluation for Patients With Diabetes (KED) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 13, 2025
Medication Adherence 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 12, 2025
Medication Adherence 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 9, 2025
Advanced Illness and Frailty 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 9, 2025
Transition of Care (TRC) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 8, 2025
Breast Cancer Screening (BCS-E) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 7, 2025
Follow‑up After Emergency Department Visit for Patients With Multiple High‑Risk Chronic Conditions (FMC) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 6, 2025
Adult Immunization Status (AIS‑E) 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 6, 2025
HEDIS Desktop Reference Guide for Commercial 2025Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025
Enhance billing and coding accuracy with new Payment Integrity trainingAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025
Specialty pharmacy precertification list expansionEffective March 1, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025
Specialty Pharmacy Precertification and Step Therapy list expansionEffective April 1, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025
Important information about specialty prescriptionsAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025
Notice of material change/amendment to contract
Reimbursement policy update: Nurse Practitioner and Physician Assistant Services — ProfessionalAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025
Introducing Coupe Health — quality care with clear pricing and no upfront paymentsAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025
CAA: Providers required to verify online provider directory informationAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025
Announcing Health Perks — earn rewards for your healthcare activitiesAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025
Kroger Specialty Pharmacy acquisitionAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — January 2025Anthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025
2025 FEHB and PSHB information available onlineAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025
Shortage of repackaged bevacizumab for ophthalmic useAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 30, 2024
Enhance patient coordination with Total Member View