Anthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

August 2018 Anthem Maine Provider Newsletter

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Sign-up today for Network eUPDATE - it’s free!

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Automated claim edits for professional claims to be enhanced

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Colonoscopy and related anesthesia services billing

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Vaginal birth after cesarean (VBAC) certified shared decision making aid available on anthem.com

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Gestational age required for professional delivery claims effective November 1, 2018

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Penalties for late pre-certification update

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Prior authorization requests for prescription medications accepted online

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Clinical practice and preventive health guidelines available on anthem.com

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Availity EDI Gateway

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Availity EDI Gateway services training webinars scheduled

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

MyDiversePatients.com

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Member Explanation of Benefits gets a makeover

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Provider Transparency Update

Behavioral Health

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Anthem engages with Alliant Health Solutions

Policy Updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Medical policy updates are available on anthem.com

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Clinical guideline updates are available on anthem.com

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Bundled Services and Supplies - professional

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Once per Lifetime Procedures - professional

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

AIM Radiation Oncology Clinical Appropriateness Guidelines updates

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

AIM Advanced Imaging Clinical Appropriateness Guidelines updates

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

AIM Level of Care Musculoskeletal Surgery Clinical Appropriateness Guidelines updates

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

New pre-service clinical review requirement for EGD services begins November 1, 2018

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Additional support available for members with rare conditions

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Mailing address for Federal Employee Program® (FEP) paper claims and claims-related correspondence

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Pharmacy information available on anthem.com

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Drug lists supporting commercial health plans updated

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Daily morphine equivalent dosing limit to apply effective September 1, 2018

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Pre-service clinical review drug list changes effective November 1, 2018

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Level of care pre-service clinical review drug list changes effective November 1, 2018

State Health Benefit PlanAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

State of Maine employer group benefits for lab and imaging services

State Health Benefit PlanAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2018

Blood pressure cuff benefits available effective July 1, 2018 for State of Maine employer group members

State & Federal

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2018

MA members receive incentives for completing screenings

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2018

Wheelchair prior authorization information for DME providers and physicians

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2018

Submit PA medication requests electronically; new phone number for MA prescription PAs effective September 1, 2018

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2018

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2018

Keep up with Medicare news