Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

January 2025 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — January 2025

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

Introducing Coupe Health — quality care with clear pricing and no upfront payments

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

Announcing Health Perks — earn rewards for your healthcare activities

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

CAA: Providers required to verify online provider directory information

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 30, 2024

Enhance patient coordination with Total Member View

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Policy Updates

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageDecember 6, 2024

Clinical Criteria updates

Effective January 9, 2025

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageDecember 19, 2024

Notice of material change/amendment to contract

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageDecember 4, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective January 5, 2025

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

Notice of material change/amendment to contract

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services — Professional

Products & Programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

2025 FEHB and PSHB information available online

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

Specialty pharmacy precertification list expansion

Effective March 1, 2025

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

Specialty Pharmacy Precertification and Step Therapy list expansion

Effective April 1, 2025

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

Important information about specialty prescriptions

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJanuary 1, 2025

Shortage of repackaged bevacizumab for ophthalmic use

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

Kroger Specialty Pharmacy acquisition

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 27, 2024

Weight management program overview

MEBCBS-CRCM-074627-24

For questions regarding Commercial plans in Maine, call Provider Services at 833-690-2936.