Maine
Provider Communications

Provider Spotlight

May 29, 2020

Information from Anthem for Care Providers about COVID-19 (updated May 29, 2020)

We recently updated FAQs to reflect the extension of coverage for telehealth and telephonic care.

May 29, 2020

Anthem Waives Cost Share for COVID-19 Treatment (updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.

May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.


Articles Recent

Title Publication Category Date

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (updated May 19, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 13, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Maine Administrative May 29, 2020

Information from Anthem for Care Providers about COVID-19 (updated May 29, 2020)

We recently updated FAQs to reflect the extension of coverage for telehealth and telephonic care.
COVID-19 Information - Maine Administrative May 29, 2020

Anthem Waives Cost Share for COVID-19 Treatment (updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Maine Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Maine Administrative May 29, 2020

Important update and clarity regarding National Medical Funding Services

COVID-19 Information - Maine Administrative May 8, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Maine Administrative May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Clinical criteria updates for specialty pharmacy

May 2020 Anthem Maine Provider News Pharmacy May 1, 2020

Specialty pharmacy updates effective August 1, 2020

May 2020 Anthem Maine Provider News Pharmacy May 1, 2020

View all COVID-19 related articles in one repository location - COVID-19 Information - Maine

COVID-19 Information - Maine Administrative May 1, 2020

Provider Manual to be updated July 1, 2020

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Reminder about system updates

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Quality Corner - Diabetes HbA1c<8 HEDIS guidance

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Commercial Risk Adjustment (CRA) Prospective Program update: Assessing patients for risk adjustable conditions

May 2020 Anthem Maine Provider News Administrative May 1, 2020

Reimbursement policy update: Claims Requiring Additional Documentation (facility)

May 2020 Anthem Maine Provider News Reimbursement Policies May 1, 2020

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

May 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines May 1, 2020

Unlisted, Unspecified or Miscellaneous Codes policy update effective August 1, 2020

May 2020 Anthem Maine Provider News Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Maine Provider News Medicare May 1, 2020

Keep up with Medicare news

May 2020 Anthem Maine Provider News Medicare May 1, 2020

Updated COVID-19 Medicare Information

COVID-19 Information - Maine Medicare Apr 20, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. 
COVID-19 Information - Maine Administrative Apr 10, 2020

Anthem to delay most April 1 formulary list updates for commercial health plan pharmacy benefit

COVID-19 Information - Maine Pharmacy Apr 1, 2020

Specialty pharmacy updates effective July 1, 2020

April 2020 Anthem Maine Provider News Pharmacy Apr 1, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Maine Provider News Pharmacy Apr 1, 2020

Information from Anthem for Care Providers about COVID-19

Bookmark Provider News Home for the latest information for Care Providers about COVID-19.
April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Anthem acquires Beacon Health Options

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Continued focus on updates to public provider website

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Provider transparency update

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical records request requirements

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Medical drug benefit clinical criteria updates - November 2019

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Medical drug benefit clinical criteria updates - December 2019

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

New enhancements with Provider News

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Reminder: non-physical, occupational or speech therapists must include modifiers on physical, occupational, or speech therapy claims

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Patient360 enhancement for medical providers

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Commercial Risk Adjustment (CRA) Program update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Modifier use reminders

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Important coding reminder for Walk-in Retail Health Clinics

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Provider Maintenance Form (PMF) enhancement

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Clinical guideline update effective June 1, 2020 - Paraesophageal Hernia Repair

March 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements effective April 1, 2020

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

Non-preferred products and corresponding preferred alternatives

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

February 2020 Anthem Maine Provider News Products & Programs Feb 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

February 2020 Anthem Maine Provider News Products & Programs Feb 1, 2020

Behavioral health outpatient visits for 2020

February 2020 Anthem Maine Provider News Behavioral Health Feb 1, 2020

Formulary lists updated for commercial health plans

February 2020 Anthem Maine Provider News Pharmacy Feb 1, 2020

CLIA claim requirements effective May 1, 2020

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

Shine Light on Depression school-based suicide prevention initiative

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

SOAP Notes Health Assessments for 2019 calendar year due February 15, 2020

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

Medical policy updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical guideline updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Modifier 62 policy update: Co-Surgeons

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

Many Anthem members received new ID numbers effective January 1, 2020

Many Anthem members received new ID numbers effective January 1, 2020 - Maine Administrative Jan 9, 2020

New musculoskeletal and pain management solution effective for select National ASO accounts January 1, 2020

January 2020 Anthem Maine Provider News Products & Programs Jan 1, 2020

Postponed: review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Outpatient facility edit implementation effective April 26, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Important update: Milliman Care Guideline (MCG), 23rd Edition, Pelvic Organ Prolapse Repair

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Upcoming retirement planned for legacy medical attachment submission tool

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Let us help you accomplish your 2020 “To Do” list early - EDI migration

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

New Year brings new ID cards for many Anthem members

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Sign up today for provider eUpdates

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

2020 FEP® benefit information available online

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medicare preferred continuous glucose monitors

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medical drug benefit clinical criteria updates - August 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medical drug benefit clinical criteria updates - September 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Postponed - review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Maine Provider News Products & Programs Dec 1, 2019

Coding reminder for psychological and neuropsychological testing

December 2019 Anthem Maine Provider News Behavioral Health Dec 1, 2019

Retrieve Anthem member HEDIS® care gaps through Patient360 on the Availity Portal

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

System updates for 2020 - professional

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Payment recovery process simplified for National Accounts membership

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

National Consumer Cost Tool (NCCT) provider cost data available for review

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Case Management Program

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Coordination of care

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Important information about utilization management

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Members’ Rights and Responsibilities

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

New Reimbursement Policies: Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers - professional

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Coordination of benefits for an FEP® member

December 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Dec 1, 2019
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