Maine
Provider Communications

Provider Spotlight

Jan 18, 2022

Important COVID-19 update: Prior authorization and other policy adjustments (updated January 18, 2021)

We recently updated prior authorization requirements for patient transfers from acute inpatient hospitals to skilled nursing facilities.

Jan 1, 2022

BlueHPN network live in Maine for 2022

Dec 30, 2021

Information from Anthem for Care Providers about COVID-19 (updated December 30, 2021)

We recently updated information about coverage dates for telephonic-only care.


Articles Recent

Title Publication Category Date

Important COVID-19 update: Prior authorization and other policy adjustments (updated January 18, 2021)

We recently updated prior authorization requirements for patient transfers from acute inpatient hospitals to skilled nursing facilities.
COVID-19 Information - Maine Administrative Jan 18, 2022

New Medicare Advantage plan will have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing providers nationally

Effective April 1, 2022, approximately 200,000 Medicare-eligible City of New York retirees across the United States will transition to the NYC Medicare Advantage Plus plan and have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.


Important Update for New 200k Group Retiree PPO Plan - Maine Medicare Jan 5, 2022

Notices of material changes/amendments to contract

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 article:

  • Medical policy and clinical guideline updates
January 2022 Anthem Maine Provider News Administrative Jan 1, 2022

Well-child visits: Know the numbers

January 2022 Anthem Maine Provider News Administrative Jan 1, 2022

Medical policy and clinical guideline updates

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

BlueHPN network live in Maine for 2022

January 2022 Anthem Maine Provider News Products & Programs Jan 1, 2022

2022 FEP® benefit information available online

January 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Professional claims - billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Important update on Botox® for Medicare members of AMH Health, LLC

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Keep up with Medicare news

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Information from Anthem for Care Providers about COVID-19 (updated December 30, 2021)

We recently updated information about coverage dates for telephonic-only care.
COVID-19 Information - Maine Administrative Dec 30, 2021

Anthem is transitioning to the Availity Authorization App

Availity Authorization App improvements based on your feedback
Availity Authorization App improvements - Maine Digital Tools Dec 28, 2021

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Blue Precision program to be retired on December 31, 2021

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

IMPORTANT: Taxonomy codes for APRNs, mid-wives, physician assistants, and behavioral health facilities billing on CMS-1500 form

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Important information about utilization management

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Submitting prior authorizations is getting easier

Anthem is transitioning to the Availity Authorization app
December 2021 Anthem Maine Provider News Digital Tools Dec 1, 2021

Is prior authorization required?

Answering your questions about the new Availity Authorization App
December 2021 Anthem Maine Provider News Digital Tools Dec 1, 2021

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Behavioral healthcare appointment access requirements

December 2021 Anthem Maine Provider News Behavioral Health Dec 1, 2021

Drug Screen Testing policy update - effective March 1, 2022

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Somatus is your resource for kidney care management

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Keep up with Medicare news

  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • Medical Policies and Clinical Utilization Management Guidelines update
December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Professional system updates for 2022

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Outpatient system updates for 2022

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Importance of PCP after-hours messaging

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Chlamydia screening for teens and young adults

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Member rights and responsibilities

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Coordination of care

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Case Management Program

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Clinical practice and preventive health guidelines available on anthem.com

December 2021 Anthem Maine Provider News Administrative Dec 1, 2021

Reminder: EnrollSafe is available

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021
December 2021 Anthem Maine Provider News Digital Tools Dec 1, 2021

Reimbursement policy update: Assistant at Surgery (modifiers 80, 81, 82, AS) - professional

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - professional and facility

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - professional

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Clinical criteria updates for specialty pharmacy

December 2021 Anthem Maine Provider News Pharmacy Dec 1, 2021

Specialty pharmacy updates - December 2021

December 2021 Anthem Maine Provider News Pharmacy Dec 1, 2021

Pharmacy information available on anthem.com

December 2021 Anthem Maine Provider News Pharmacy Dec 1, 2021

Register today for a forum on Grief and Loss: The disproportionate impact of the pandemic on communities of color

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about the disproportionate impact of the pandemic on communities of color.
Grief & Loss Forum - Maine Administrative Nov 29, 2021

Update on claims processing

Anthem Blue Cross and Blue Shield in Maine continues to manage workflow challenges that have caused delays in our ability to properly process and pay claims to some providers. To support you during this time, we have established a team dedicated to Maine healthcare providers.
Important update from Anthem in Maine Administrative Nov 22, 2021

Time to prepare for HEDIS® medical record review

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

Surprisingly easy ways to help patients quit smoking cigarettes

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

CME credits available in 2021 for a variety of clinical quality webinars - register now!

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

Join Anthem in talking about racism and its impact on health, and earn continuing education credits!

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

Be Antibiotics Aware: Protect your patient

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

Change in coverage for continuous glucose monitors for some fully insured groups

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

Include referring provider name and NPI on home infusion therapy and ambulatory infusion suite professional claims

November 2021 Anthem Maine Provider News Administrative Nov 1, 2021

EnrollSafe is available: Our new electronic funds transfer enrollment portal for Anthem providers

EnrollSafe replaces CAQH Enrollhub effective November 1, 2021
November 2021 Anthem Maine Provider News Digital Tools Nov 1, 2021

Reducing the burden of medical record review and improving health outcomes with ECDS HEDIS reporting

November 2021 Anthem Maine Provider News Digital Tools Nov 1, 2021

Against medical advice (AMA) discharge physician tracking tool

November 2021 Anthem Maine Provider News Digital Tools Nov 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Maine Provider News Reimbursement Policies Nov 1, 2021

New Blue HPN® network included in plans available for employee open enrollment Fall 2021

November 2021 Anthem Maine Provider News Products & Programs Nov 1, 2021

Update regarding annual wellness visits for ACA-compliant health plans

November 2021 Anthem Maine Provider News Products & Programs Nov 1, 2021

Important update on Botox® for Anthem members

November 2021 Anthem Maine Provider News Pharmacy Nov 1, 2021

Specialty pharmacy updates - November 2021

November 2021 Anthem Maine Provider News Pharmacy Nov 1, 2021

AMH Health, LLC offering advance medical directives program for 2022

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Keep up with Medicare news

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Join The Fenway Institute for a CME webinar about improving your LGBTQIA+ patient interactions

Join a live webinar, “LGBTQIA+ Care: Delivering Trust and Belonging with Every Interaction", presented by the National LGBTQIA+ Health Education Center at The Fenway Institute. 

Gain LGBTQIA+ Patient Interaction Knowledge - Maine Administrative Oct 21, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan - Maine Medicare Oct 19, 2021

Update on processing delays for provider applications and provider maintenance forms

Important message from Anthem in Maine Administrative Oct 13, 2021

Submit claims with complete and correct data to avoid claim denials

Submit claims with complete data to avoid claim denials - Maine Administrative Oct 8, 2021

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management


Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Clinical Quality CME Webinar Series Continues - Maine Administrative Oct 5, 2021

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

October 2021 Anthem Maine Provider News Administrative Oct 1, 2021

Looking to earn CME credits? Register for on-demand webinars

Provider News test publication Administrative Oct 1, 2021

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

October 2021 Anthem Maine Provider News Administrative Oct 1, 2021

Are you talking to ALL of your patients about breast cancer screenings?

Provider News test publication Administrative Oct 1, 2021

Clinical appeals

October 2021 Anthem Maine Provider News Administrative Oct 1, 2021

Your recommendation is key to encouraging cancer screenings for your female patients

October 2021 Anthem Maine Provider News Administrative Oct 1, 2021

Reminder: EnrollSafe replacing CAQH Enrollhub effective November 1, 2021

October 2021 Anthem Maine Provider News Digital Tools Oct 1, 2021

Procedure searches in Find Care

October 2021 Anthem Maine Provider News Digital Tools Oct 1, 2021

Submit provider claim payment disputes for Anthem’s Commercial lines of business via Availity beginning October 19, 2021

October 2021 Anthem Maine Provider News Digital Tools Oct 1, 2021

Good news! Non-payment remittance advice enhancements coming soon

October 2021 Anthem Maine Provider News Digital Tools Oct 1, 2021

Reimbursement policy clarification: Claims Requiring Additional Documentation - facility

October 2021 Anthem Maine Provider News Reimbursement Policies Oct 1, 2021

New reimbursement policy: Multiple and Bilateral Surgery Processing - facility

October 2021 Anthem Maine Provider News Reimbursement Policies Oct 1, 2021

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

October 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Oct 1, 2021

Clinical criteria updates for specialty pharmacy

October 2021 Anthem Maine Provider News Pharmacy Oct 1, 2021

New medical step therapy requirements

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Specialty pharmacy updates - October 2021

October 2021 Anthem Maine Provider News Pharmacy Oct 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Pharmacy information available on anthem.com

October 2021 Anthem Maine Provider News Pharmacy Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

New reimbursement policy effective January 1, 2022 - Sexually Transmitted Infections Testing - professional

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Keep up with Medicare news

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Exploring the Impact of Racial Trauma on the Health & Wellbeing of Children Forum

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about the impact of racial trauma on the health and wellbeing on children and adolescents.

Racial Trauma & Children - Maine Administrative Sep 15, 2021

Register now for our September CME webinars!

September 2021 Maine Provider News Administrative Sep 1, 2021

National Accounts 2022 Pre-certification list

September 2021 Maine Provider News Administrative Sep 1, 2021

Cure for the common cold: rest, fluids and this free prescription pad

Be Antibiotic Aware campaign offers a prescription solution to antibiotics
September 2021 Maine Provider News Administrative Sep 1, 2021
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