Anthem Blue Cross and Blue Shield | CommercialDecember 1, 2019

December 2019 Anthem Maine Provider News

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Members’ Rights and Responsibilities

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Important information about utilization management

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Coordination of care

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Case Management Program

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Clinical practice and preventive health guidelines available on anthem.com

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

National Consumer Cost Tool (NCCT) provider cost data available for review

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Verifying and updating your provider information

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Payment recovery process simplified for National Accounts membership

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

System updates for 2020 - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Retrieve Anthem member HEDIS® care gaps through Patient360 on the Availity Portal

Behavioral Health

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Coding reminder for psychological and neuropsychological testing

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Coordination of benefits for an FEP® member

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Pharmacy information available on anthem.com

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 30, 2019

Clinical criteria updates for specialty pharmacy

State & Federal

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Reminder: refer Medicare Advantage members to in-network providers

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Medical drug clinical criteria updates

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

AMH Health, LLC (Anthem | MaineHealth) reimbursement policies

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Introducing Interactive Care Reviewer

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Anthem | MaineHealth to offer three new health maintenance organizations in 2020

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Electronic data interchange

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Prior authorization requirements for E0784, K0553 and K0554

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Global 3M19 Medical Policy and Technology Assessment Committee prior authorization updates

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

Group Retiree PPO plans

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

CMS reminder: expedited/urgent requests

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 30, 2019

2020 Medicare Advantage individual benefits and formularies