Anthem Blue Cross and Blue Shield | CommercialJuly 1, 2019

July 2019 Anthem Maine Provider News

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Modifier 79 reminder - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

ICD-10-CM coding guidelines and laterality - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Modifier 63 reminder - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

State-supplied vaccines reminder - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Make the move to the Availity EDI Gateway today

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Changes to Claim Status Inquiry and Secure Messaging on the Availity Portal

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Payment recovery process simplified for National Accounts membership

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Clinical validation - professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Update to provider/facility UM reimbursement penalties and corresponding update to Provider/Facility Manual

Policy Updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Un-adopted clinical guidelines effective June 1, 2019

Products & Programs

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

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

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

Federal Employee Health Benefit Program® (FEP) PPO members will now require prior approval for specific specialty drugs and site of care

PharmacyAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Clinical criteria coding updates for specialty pharmacy

PharmacyAnthem Blue Cross and Blue Shield | CommercialJune 30, 2019

Clinical criteria updates for specialty pharmacy

State & Federal

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

Keep up with Medicare news

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

Outpatient Rehabilitation Program transitioning to AIM

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

Home health billing guidelines for contracted providers

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

Sepsis diagnosis coding and billing reminder

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

Electronic claim payment reconsideration