Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 1, 2023

December 2023 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Notice of material change/amendment to contract

Notices of material changes/amendments to contract – December 2023

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

CarelonRx, Inc. Mail will change to CarelonRx Pharmacy on January 1, 2024

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 1, 2023

Model of care training reminder

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 1, 2023

Your requests for additional information will be sent digitally in mid-January

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

New vendor administering behavioral health access survey

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

New vendor administering Primary Care Access Survey

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Important information about utilization management

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Outpatient system updates for 2024

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Professional system updates for 2024

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 1, 2023

New requirements for credentialing and recredentialing

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Case Management Program

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Coordination of care

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

CAA: Review your online provider directory information

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Clinical practice and preventive health guidelines

AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Members’ Rights and Responsibilities

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Clinical Documentation Lookup Tool

Policy Updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Notice of material change/amendment to contract

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 21, 2023

Medical Policies and Clinical Utilization Management Guidelines update for May 2023

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 17, 2023

Transition to Carelon Medical Benefits Management, Inc. Genetic Testing Guidelines

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialOctober 27, 2023

Notice of material change/amendment to contract

Transition to Carelon Medical Benefits Management, Inc. Genetic Testing Guidelines

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 15, 2023

Prior authorization requirement changes effective May 1, 2024 

Codes 0738T and 0739T

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 15, 2023

Prior authorization requirement changes effective May 1, 2024 

Codes Q4272 - Q4284

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 8, 2023

Prior authorization requirement changes effective May 1, 2024 

Code E0761

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2023

Prior authorization requirement changes effective March 1, 2024 

Codes 33275 and 33274

Products & Programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Federal Employee Program updates member ID cards

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | Medicare AdvantageDecember 1, 2023

2024 Federal Employee Program Benefit information available online

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2023

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Pharmacy information available on our provider website

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 26, 2023

Notification of specialty pharmacy medical step therapy updates

Quality Management

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 13, 2023

HEDIS 2023 Electronic Clinical Data Systems (ECDS)

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 10, 2023

HEDIS 2023 Electronic Clinical Data Systems (ECDS)

MEBCBS-CRCM-045271-23

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).