Maine
Provider Communications

December 2019 Anthem Maine Provider News

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Title Category

Reminder: New AIM Rehabilitative Program effective November 1, 2019

Products & Programs

Coding reminder for psychological and neuropsychological testing

Behavioral Health

Clinical criteria updates for specialty pharmacy

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

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

Administrative

System updates for 2020 - professional

Administrative

Payment recovery process simplified for National Accounts membership

Administrative

Verifying and updating your provider information

Administrative

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

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Case Management Program

Administrative

Coordination of care

Administrative

Important information about utilization management

Administrative

Members’ Rights and Responsibilities

Administrative

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

Administrative

Coordination of benefits for an FEP® member

Federal Employee Plan (FEP)

2020 Medicare Advantage individual benefits and formularies

Medicare

CMS reminder: expedited/urgent requests

Medicare

Group Retiree PPO plans

Medicare

Global 3M19 Medical Policy and Technology Assessment Committee prior authorization updates

Medicare

Prior authorization requirements for E0784, K0553 and K0554

Medicare

Electronic data interchange

Medicare

Anthem | MaineHealth to offer three new health maintenance organizations in 2020

Medicare

Introducing Interactive Care Reviewer

Medicare

AMH Health, LLC (Anthem | MaineHealth) reimbursement policies

Medicare

Medical drug clinical criteria updates

Medicare

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

Medicare

Reminder: refer Medicare Advantage members to in-network providers

Medicare
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