Anthem Blue Cross and Blue Shield | CommercialNovember 1, 2019

November 2019 Anthem Maine Provider News

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Additional improvements coming to anthem.com

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Reminder: new AIM Rehabilitative Program effective November 1, 2019

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Appropriate coding helps provide a comprehensive picture of patients’ health

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Modifier use reminders

Policy Updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Medical policy updates are available on anthem.com

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Clinical guideline updates are available on anthem.com

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guidelines

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Pre-service clinical review and quantity limit updates for specialty pharmacy effective February 1, 2020

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2019

Clinical criteria updates for specialty pharmacy

State & Federal

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

2019 Enhanced Personal Health Care Program releases myFHR

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

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

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

Reimbursement Policy update: Drug Screen Testing

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

Rehabilitative services prior authorization review update for Medicare Advantage members

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

CMS reminder: expedited/urgent requests

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2019

Bill Medicare Part D for shingles or tetanus vaccination claims