Maine
Provider Communications

October 2020 Anthem Maine Provider News

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Title Category

Reminder: Expansion of AIM Musculoskeletal Program effective November 1, 2020

Products & Programs

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines delayed until December 1, 2020

Products & Programs

FDA approvals and expedited pathways used - new molecular entities (NMEs)

Pharmacy

Prior authorization updates for specialty pharmacy effective January 2021

Pharmacy

Clinical criteria updates for specialty pharmacy

Pharmacy

Formulary lists updated for commercial health plan pharmacy benefit

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Evaluation and management services correct coding - professional

Administrative

National drug code requirement on outpatient claims

Administrative

Anthem Chat: A fast, easy way to have your questions answered

Administrative

Predictive analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

Administrative

Updated coverage for breast cancer prevention medications

Administrative

Commercial Risk Adjustment reporting update: New guidance on telephone-only service CPT codes for risk adjustment program

Administrative

National Accounts 2021 Pre-certification list

Administrative

New Availity medical claim attachment webinars: register today

Administrative

Electronic member ID cards available on the Availity portal

Administrative

What Matters Most online CME course: Improving the Patient Experience

Administrative

Reimbursement policy update - Emergency Department: Leveling of Evaluation and Management Services (facility)

Reimbursement Policies

Reimbursement policy update: Laboratory and Venipuncture - professional

Reimbursement Policies

Reimbursement policy update - Claims Requiring Additional Documentation policy (facility)

Reimbursement Policies

Medical policy and clinical guideline updates

Medical Policy & Clinical Guidelines

Federal Employee Program expands specialty pharmacy prior authorization list

Federal Employee Plan (FEP)

Social determinants of health support expanding with GroundGame Health

Medicare

Patient360 enhancement for medical providers

Medicare

Prior authorization requirement changes effective December 1, 2020

Medicare

Prior authorization requirement changes effective January 1, 2021

Medicare

Provider transparency update

Medicare

Medical drug benefit clinical criteria updates

Medicare

Keep up with Medicare news

Medicare
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