Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 1, 2023

September 2023 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Notices of material changes/amendments to contract – September 2023

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 27, 2023

Help your patients continue their care and navigate Medicaid renewal

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

HCPCS to revenue code alignment

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

CAA: Have you reviewed your online provider directory information lately?

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requests

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Consider a FIT kit for your patients aged 45 and older at average risk for colon cancer

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Improvements to Digital RFAI Attachment filtering and reporting

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 1, 2023

Personalized match phase 1: Specialist provider overview

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Simplifying claims attachments: Digital Request for Additional Information through Availity.com

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 1, 2023

Submitting prior authorizations is getting easier

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Member search feature enhancement: Search for a patient without using member ID in Availity Essentials

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 7, 2023

You're invited: Thriving, not just surviving: Youth mental health in today's world

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 10, 2023

You're invited: Thriving, not just surviving: Youth mental health in today's world

Policy Updates

Policy UpdatesAMH Health, LLC | Medicare AdvantageAugust 8, 2023

Clinical Criteria updates - May 2023

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 7, 2023

Prior authorization requirement changes effective December 1, 2023

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Notice of material change/amendment to contract

Precertification list change notification effective December 1, 2023
Notice of material change/amendment to contract.

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 24, 2023

Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list update

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Notice of material change/amendment to contract

Reimbursement policy update: Documentation Standards for Episodes of Care — Professional

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

New reimbursement policy: Split Care Surgical Modifiers — Professional

Products & Programs

PharmacyAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Notice of material change/amendment to contract

Specialty pharmacy updates – September 2023

PharmacyAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy
Notice of material change/amendment to contract.

PharmacyAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Sublocade® update

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 3, 2023

Specialty pharmacy medical step therapy for hyaluronan injections

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 28, 2023

UPDATED: AMH Health, LLC expands specialty pharmacy precertification list

Quality Management

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 1, 2023

Medication reconciliation post inpatient discharge

MEBCBS-CRCM-035542-23

Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan. Availity, LLC is an independent company providing administrative support services on behalf of the health plan.