Maine
Provider Communications

July 2022 Anthem Maine Provider News

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Title Category

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Administrative

Notices of material changes/amendments to contract - July 2022

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 articles:

  • Clinical criteria updates for specialty pharmacy
Administrative

Enhanced reimbursement for voluntary Cancer Care Quality Program to be discontinued effective December 31, 2022

Administrative

Update to facility editing: HCPCS code G0463

Administrative

Help patients heal from the comfort of home with Hospital in Home care

Administrative

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

Administrative

Clearing up coding confusion for diabetic retinal screenings

Administrative

CAA: Keep your provider directory information current

Administrative

Enhancing claims attachment processes through digital applications: Add attachments through Claims Status Inquiry

Digital Tools

Coming soon: Anthem Provider Learning Hub makes Availity learning easier

Digital Tools

New reimbursement policy: Transitional Care Management - Professional

Reimbursement Policies

Retraction for reimbursement policy - Sexually Transmitted Infections – Professional

Reimbursement Policies

Clinical criteria updates for specialty pharmacy

Notice of Material Change/Amendment to Contract
Pharmacy

Pharmacy information available online

Pharmacy

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

State Health Benefit Plan

Cancer Care Navigator

Medicare

MCG care guidelines 26th edition

Medicare

Keep up with Medicare news

New specialty pharmacy medical step therapy requirements
Medicare
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