Maine
Provider Communications

April 2019 Anthem Maine Provider Newsletter

Download as PDF

Title Category

Chronic care management and advanced care planning service benefits

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Commercial risk adjustment (CRA) reporting update

Administrative

Keep up with Medicare news

Medicare

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

Administrative

New AIM Rehabilitative program effective July 1, 2019

Products & Programs

New Partial Hospitalization Program and Intensive Outpatient Program Services Facility Reimbursement Policy

Reimbursement Policies

Pharmacy information available on anthem.com

Pharmacy

Provider manual to be updated July 1, 2019

Administrative

Reimbursement for select HEDIS related CPT II codes for Medicare Advantage members coming soon

Medicare

Specialty pharmacy pre-service clinical review list expanded effective July 1, 2019

Pharmacy

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

Reimbursement Policies

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

Medicare

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines

Products & Programs

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline

Products & Programs

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines

Products & Programs

Why do patients stop taking their prescribed medications and what can you do to help them?

Administrative
Page 1 of 1