Anthem Blue Cross and Blue Shield | CommercialSeptember 1, 2019

September 2019 Anthem Maine Provider News

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Anthem launches Sydney on September 1; new app offers better digital health care support to members

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Reminder: Changes to timely filing requirements coming in October

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Controlling high blood pressure

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Claim editing update for Excludes1 notes

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Provider transparency update

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Appointment access standards for primary care, specialty care and behavioral health practitioners

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

PCP after-hours access requirements

Behavioral Health

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Access requirements for behavioral healthcare services

Policy Updates

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

Medical policy updates are available on anthem.com

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

Clinical guideline updates are available on anthem.com

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

New Clinical Guideline: Pneumatic Compression Devices effective December 1, 2019

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

New Reimbursement Policies - Maternity Services and Multiple Delivery - professional

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

New Reimbursement Policy - Intensity Modulated Radiation Therapy Planning and Delivery - professional

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Claims requiring additional documentation facility reimbursement policy update

Products & Programs

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Clinical criteria updates for specialty pharmacy

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 31, 2019

Specialty pharmacy prior authorization list to be expanded effective December 1, 2019

State & Federal

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

Electronic attachments coming soon

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

Clinical criteria updates

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

Customizations to the 23rd edition of the MCG Care Guidelines

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

Changes to prior authorization requirements effective December 1, 2019

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

Pharmacy benefit manager change to IngenioRx

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

Keep up with Medicare news