Maine
Provider Communications

May 2019 Anthem Maine Provider Newsletter

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Title Category

Specialty pharmacy medical step therapy drug list clarification about non-oncology colony stimulating factor agents

Pharmacy

Specialty pharmacy medical step therapy drug list expanded

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

MCG care guidelines 23rd Edition

Administrative

Electronic member ID cards – Easy online access on the Availity portal

Administrative

Attention! Availity launches changes to the Medical Attachment submission tool

Administrative

Provider manual to be updated July 1, 2019

Administrative

Commercial Risk Adjustment (CRA) Reporting Update: Health Assessment requests for 2019 / Alternative reporting engagement

Administrative

Review of professional claims with emergency room level 5 E/M codes

Administrative

Referring to contracted ambulance providers

Administrative

Good HbA1c <8

Administrative

Drug Screen Testing update: professional

Reimbursement Policies

Medical policy updates are available on anthem.com

Medical Policy & Clinical Guidelines

Clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

State of Maine Health Plan benefits for blood pressure cuffs

State & Federal

Fall prevention tips

Medicare

Medical records request for risk adjustment

Medicare

Partial hospitalization services

Medicare

Keep up with Medicare news

Medicare

Clinical practice and preventive health guidelines available on anthem.com

Administrative
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