Maine
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

2023 Medicare Advantage service area and benefit updates

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Personal home helper benefit ending

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Remote EMR access service for HEDIS

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Personalized Match

November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
November 2022 Provider Newsletter - Maine Medicare Nov 1, 2022

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

October 2022 Provider Newsletter – Maine Federal Employee Plan (FEP) Oct 1, 2022

Monkeypox and smallpox vaccines: Product code on claims

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

Keep up with Medicare news

  • Medicare Part B Precert Expansion Alymsys
  • Medicare Part B Precert Expansion Amvuttra Xipere
  • Consultation Codes
October 2022 Provider Newsletter – Maine Medicare Oct 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Reimbursement policy update - Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003)

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AMH Health LLC. expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Keep up with Medicare news    

  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
  • Clinical Criteria updates

 

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

July 2022 Anthem Maine Provider News State Health Benefit Plan Jul 1, 2022

Cancer Care Navigator

July 2022 Anthem Maine Provider News Medicare Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Anthem Maine Provider News Medicare Jul 1, 2022

Keep up with Medicare news

New specialty pharmacy medical step therapy requirements
July 2022 Anthem Maine Provider News Medicare Jul 1, 2022

Medical policies and clinical utilization management guidelines update

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Medical drug benefit clinical criteria updates

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Evaluation and management services for COVID testing - professional

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Keep up with Medicare news

  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • New specialty pharmacy medical step therapy requirements
  • AMH Health, LLC. expands specialty pharmacy precertification list
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Process change for Federal Employee Program® third-party correspondence requests

June 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP® Quality Reimbursement Program for PPO providers

May 2022 Anthem Maine Provider News Federal Employee Plan (FEP) May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Maine Provider News Medicare May 1, 2022

Keep up with Medicare news

  • AMH Health, LLC expands specialty pharmacy precertification list
  • AMH Health, LLC expands specialty pharmacy precertification list
  • New specialty pharmacy medical step therapy requirements

 

May 2022 Anthem Maine Provider News Medicare May 1, 2022

Join us for an FEP Quality Learning Program live webinar

May 2022 Anthem Maine Provider News Federal Employee Plan (FEP) May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Anthem Maine Provider News Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements

May 2022 Anthem Maine Provider News Medicare May 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Apr 1, 2022

Model of Care required training

April 2022 Anthem Maine Provider News Medicare Apr 1, 2022

Clinical criteria updates

April 2022 Anthem Maine Provider News Medicare Apr 1, 2022

Update - Inpatient Readmissions Policy G-13001 effective July 1, 2022

April 2022 Anthem Maine Provider News Medicare Apr 1, 2022

The impact of listening

April 2022 Anthem Maine Provider News Medicare Apr 1, 2022

Keep up with Medicare news

April 2022 Anthem Maine Provider News Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date. Read important information about this change here.
Transition to NYC Medicare Advantage Plus Delayed - Maine Medicare Mar 15, 2022

New address for Federal Employee Program® clinical grievances and appeals

March 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Mar 1, 2022

Prior authorization requirement change effective June 1, 2022

March 2022 Anthem Maine Provider News Medicare Mar 1, 2022

Clinical criteria updates

March 2022 Anthem Maine Provider News Medicare Mar 1, 2022

Annual wellness visits for Medicare Advantage members

March 2022 Anthem Maine Provider News Medicare Mar 1, 2022

Medication adherence

March 2022 Anthem Maine Provider News Medicare Mar 1, 2022

Keep up with Medicare news

  • Medical step therapy updates
  • Phone number change for AIM in Maine
March 2022 Anthem Maine Provider News Medicare Mar 1, 2022

HEDIS 2022 Federal Employee Program® medical record request requirements

March 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Mar 1, 2022

Get faster payments with EFT

February 2022 Anthem Maine Provider News Medicare Feb 1, 2022

New Medicare Advantage plan will have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing providers nationally

Effective April 1, 2022, approximately 200,000 Medicare-eligible City of New York retirees across the United States will transition to the NYC Medicare Advantage Plus plan and have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.


Important Update for New 200k Group Retiree PPO Plan - Maine Medicare Jan 5, 2022

2022 FEP® benefit information available online

January 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Professional claims - billing referring provider and NPI for home infusion therapy and ambulatory infusion suite

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Important update on Botox® for Medicare members of AMH Health, LLC

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Keep up with Medicare news

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Drug Screen Testing policy update - effective March 1, 2022

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Somatus is your resource for kidney care management

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

Keep up with Medicare news

  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • Medical Policies and Clinical Utilization Management Guidelines update
December 2021 Anthem Maine Provider News Medicare Dec 1, 2021

AMH Health, LLC offering advance medical directives program for 2022

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

Keep up with Medicare news

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan - Maine Medicare Oct 19, 2021

New medical step therapy requirements

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

New reimbursement policy effective January 1, 2022 - Sexually Transmitted Infections Testing - professional

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Keep up with Medicare news

October 2021 Anthem Maine Provider News Medicare Oct 1, 2021

Utilization management authorization rule operations

September 2021 Maine Provider News Medicare Sep 1, 2021

Prior authorization/Precertification form notification

September 2021 Maine Provider News Medicare Sep 1, 2021

Reimbursement policy update - DRG Inpatient Facility Transfers effective November 30, 2021

September 2021 Maine Provider News Medicare Sep 1, 2021

Keep up with Medicare news

September 2021 Maine Provider News Medicare Sep 1, 2021

Change in email submission of service requests for Federal Employee Program® members

August 2021 Maine Provider News Federal Employee Plan (FEP) Aug 1, 2021

Keep up with Medicare news

August 2021 Maine Provider News Medicare Aug 1, 2021

Keep up with Medicare news

July 2021 Maine Provider News Medicare Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem and AMH Health LLC results in improved patient care management

July 2021 Maine Provider News Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Maine Provider News Medicare Jul 1, 2021

Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428

July 2021 Maine Provider News Medicare Jul 1, 2021

Medical drug benefit clinical criteria update

July 2021 Maine Provider News Medicare Jul 1, 2021

New Policy - Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (effective 10/1/21)

July 2021 Maine Provider News Medicare Jul 1, 2021

Inpatient readmissions policy reminder

June 2021 Anthem Maine Provider News Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Maine Provider News Medicare Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Maine Provider News Medicare Jun 1, 2021

Keep up with Medicare news

June 2021 Anthem Maine Provider News Medicare Jun 1, 2021

DEXA bone scan criteria for the Federal Employee Program

June 2021 Anthem Maine Provider News Federal Employee Plan (FEP) Jun 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Maine Provider News Medicare May 1, 2021

Keep up with Medicare news

May 2021 Anthem Maine Provider News Medicare May 1, 2021

Medical drug benefit clinical criteria updates - November 2020

April 2021 Anthem Maine Provider News Medicare Apr 1, 2021

Medical drug benefit clinical criteria updates - December 2020

April 2021 Anthem Maine Provider News Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Maine Provider News Medicare Apr 1, 2021
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