Maine
Provider Communications

June 2019 Anthem Maine Provider Newsletter

Download as PDF

Title Category

Additional changes launched to anthem.com for Q2

Administrative

Adult BMI Assessment

Administrative

AIM programs may require additional prior authorization documentation

Products & Programs

Clinical Guideline CG-ANC-07 effective September 1, 2019

Medical Policy & Clinical Guidelines

Clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Coding Updates

Medical Policy & Clinical Guidelines

Coding Updates

Medical Policy & Clinical Guidelines

Commercial Risk Adjustment (CRA) reporting update: Retrospective Program begins; benefits of direct connection access to your EMR

Administrative

Electronic attachments coming soon

Administrative

Find a Doctor - new sort option

Administrative

Frequency Editing - professional

Reimbursement Policies

Introducing Anthem’s Maine HMO Tiered Options

Administrative

Keep up with Medicare news

Medicare

Medical non-oncology specialty drug review changes effective June 15, 2019

Pharmacy

Medical policy updates are available on anthem.com

Medical Policy & Clinical Guidelines

Misrouted protected health information (PHI)

Administrative

New Reimbursement Policy - Ambulance Transportation - professional

Reimbursement Policies

Pharmacy information available on anthem.com

Pharmacy

Reminder and update: new Rehabilitative Program effective July 1, 2019

Products & Programs

Review of professional claims with emergency department level 5 E&M codes

Medicare

Sepsis coding update

Administrative

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

Pharmacy

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

Medicare
Page 1 of 1