Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

October 2024 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — October 2024

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 12, 2024

Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracy

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 17, 2024

Changes to special supplemental benefits for the chronically ill eligibility requirements


Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

National Accounts 2025 precertification list

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Now live: view your fee schedule in Availity Essentials Payer Spaces

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 4, 2024

Digital Provider Enrollment now available for additional provider types in Availity Essentials

Education & Training

Education & TrainingAMH Health, LLC | Medicare AdvantageSeptember 16, 2024

Seamless advance care: MyDirectives digital tool for D-SNP members

Policy Updates

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 3, 2024

Clinical Criteria updates

Effective October 4, 2024

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 10, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 10, 2024

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 23, 2024

Prior authorization requirement changes

Effective January 1, 2025

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Reimbursement policy update: Modifier FB — Professional and Facility

Reimbursement PoliciesAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the Specialty High Performing Provider designation program for commercial networks

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the HPP designation program for individual member (Exchange) commercial networks

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Pharmacy information available on our provider website

PharmacyAnthem Blue Cross and Blue Shield | CommercialSeptember 16, 2024

Notice of material change/amendment to contract

Specialty pharmacy updates — October 2024

Quality Management

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

Prevent flu and COVID-19: drive the change through vaccination

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 1, 2024

HEDIS medical record submission made easier with our Remote EMR Access service

MEBCBS-CRCM-067870-24

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