Maine
Provider Communications

September 2022 Anthem Maine Provider News

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Title Category

Notices of material changes/amendments to contract - September 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:

  • Reimbursement policy update:  Modifier Rules – Professional
  • Specialty pharmacy updates - September 2022
  • Clinical criteria updates for specialty pharmacy

 

Administrative

Continuing to Explore the Intersection of Race and Disability

Administrative

Important information about women’s preventive care visits

Administrative

Anthem to accept Hospital in Home services

Administrative

Drug code billing reminder

Administrative

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

Administrative

Monkeypox resources and recommendations for our care providers

Administrative

Updates to the Claim Attachment workflow

Digital Tools

Reimbursement policy update: Modifier Rules - Professional

Notice of material change/amendment to contract
Reimbursement Policies

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

Reimbursement Policies

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional

Reimbursement Policies

New Back Pain Management Program

Products & Programs

Specialty pharmacy updates - September 2022

Notice of material change/amendment to contract
Pharmacy

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
Pharmacy

Update to formulary lists for Commercial health plan pharmacy benefit

Pharmacy

OBRA 93 claim filing for Federal Employee Program

Federal Employee Plan (FEP)

Enhancing claims attachment processes through digital applications

Medicare

Prior authorization requirement changes effective December 1, 2022

Medicare

Reimbursement policy update - Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003)

Medicare

AMH Health LLC. expands specialty pharmacy precertification list

Medicare

AMH Health, LLC expands specialty pharmacy precertification list

Medicare

Keep up with Medicare news    

  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
  • Clinical Criteria updates

 

Medicare
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