Maine
Provider Communications

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Notices of material changes/amendments to contract - July 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Clinical criteria updates for specialty pharmacy

Enhanced reimbursement for voluntary Cancer Care Quality Program to be discontinued effective December 31, 2022

Update to facility editing: HCPCS code G0463

Help patients heal from the comfort of home with Hospital in Home care

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

Clearing up coding confusion for diabetic retinal screenings

CAA: Keep your provider directory information current

Enhancing claims attachment processes through digital applications: Add attachments through Claims Status Inquiry

Coming soon: Anthem Provider Learning Hub makes Availity learning easier

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

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Exploring the Intersection of Race and Disability

Notices of material changes/amendments to contract - June 2022

Exploring the Intersection of Race and Disability forum

Provider outreach to validate your provider data

Once-a-year testing is critically important to providing quality diabetes care

CAA: Provider directories accuracy is important

Notices of material changes/amendments to contract - May 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Provider Manual updated effective July 1, 2022
• Medical policy and clinical guideline updates available on anthem.com
• Clinical criteria updates for specialty pharmacy
• Specialty pharmacy updates - May 2022

Provider Manual updated effective July 1, 2022

Primary care appointment access and open panels

Anthem announces changes to post-payment audits conducted on our behalf

May is National High Blood Pressure Education Month: We’ve got this!

Alcohol use disorder has a big cost

Resources to support diverse patients and communities

Coding tips for reporting administration of Spravato®

CAA: Timely updates help keep our provider directories current

Information from Anthem for Care Providers about COVID-19 (updated April 15, 2022)

Improving antibiotic use for acute respiratory infections in the outpatient setting

The Anthem, Inc. name is changing

HEDIS 2022: Summary of changes from NCQA

Catching up on routine vaccines

Reminder on Botox® for Anthem members

CAA: Update your provider directory information

Procedure searches in Find Care

Notices of material changes/amendments to contract – April 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following article:

• Specialty pharmacy updates - April 2022

The Anthem, Inc. name is changing

Exploring Implicit Bias in Healthcare for Historically Marginalized Communities

Notices of material changes/amendments to contract – March 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
• Clinical criteria updates for specialty pharmacy
• Correction to February 2022 specialty pharmacy updates
• Specialty pharmacy updates - March 2022

Consolidated Appropriations Act (CAA): Have you reviewed your online provider directory information lately?

Enhancements to the Availity Authorization application are now available

New! Vaccination resource page for providers

Updated preventive care guidance regarding screening colonoscopies

Understanding your patients’ differences is lifesaving

Your influence matters: Recommending cancer screenings to your patients

Simplifying requests for additional information

GN, GO, GP therapy modifier requirement paused for Anthem Maine members

Provider Manual to be updated April 4, 2022

Notices of material changes/amendments to contract

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Specialty pharmacy updates - February 2022
• Clinical criteria updates for specialty pharmacy

Prepare for the CAA: Keep your provider directory information current

Cancer Care Navigator

It is CAHPS survey time!

Heart disease is the number one killer of women

Important COVID-19 update: Prior authorization and other policy adjustments (updated January 18, 2021)

Notices of material changes/amendments to contract

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following article:

• Medical policy and clinical guideline updates

Well-child visits: Know the numbers

Anthem is transitioning to the Availity Authorization App

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Blue Precision program to be retired on December 31, 2021

IMPORTANT: Taxonomy codes for APRNs, mid-wives, physician assistants, and behavioral health facilities billing on CMS-1500 form

Important information about utilization management

Submitting prior authorizations is getting easier

Is prior authorization required?

Professional system updates for 2022

Outpatient system updates for 2022

Importance of PCP after-hours messaging

Chlamydia screening for teens and young adults

Member rights and responsibilities

Coordination of care

Case Management Program

Clinical practice and preventive health guidelines available on anthem.com

Reminder: EnrollSafe is available

Register today for a forum on Grief and Loss: The disproportionate impact of the pandemic on communities of color

Update on claims processing

Time to prepare for HEDIS® medical record review

Surprisingly easy ways to help patients quit smoking cigarettes

CME credits available in 2021 for a variety of clinical quality webinars - register now!

Join Anthem in talking about racism and its impact on health, and earn continuing education credits!

Be Antibiotics Aware: Protect your patient

Change in coverage for continuous glucose monitors for some fully insured groups

Include referring provider name and NPI on home infusion therapy and ambulatory infusion suite professional claims

EnrollSafe is available: Our new electronic funds transfer enrollment portal for Anthem providers

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

Against medical advice (AMA) discharge physician tracking tool

Join The Fenway Institute for a CME webinar about improving your LGBTQIA+ patient interactions

Join a live webinar, “LGBTQIA+ Care: Delivering Trust and Belonging with Every Interaction", presented by the National LGBTQIA+ Health Education Center at The Fenway Institute. 

Update on processing delays for provider applications and provider maintenance forms

Submit claims with complete and correct data to avoid claim denials

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management

Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

Looking to earn CME credits? Register for on-demand webinars

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

Are you talking to ALL of your patients about breast cancer screenings?

Clinical appeals

Your recommendation is key to encouraging cancer screenings for your female patients

Reminder: EnrollSafe replacing CAQH Enrollhub effective November 1, 2021

Procedure searches in Find Care

Submit provider claim payment disputes for Anthem’s Commercial lines of business via Availity beginning October 19, 2021

Good news! Non-payment remittance advice enhancements coming soon

Exploring the Impact of Racial Trauma on the Health & Wellbeing of Children Forum

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about the impact of racial trauma on the health and wellbeing on children and adolescents.

Register now for our September CME webinars!