Maine
Provider Communications

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

Electronic claim response files

Provider Learning Hub is here

Updates to the Claim Attachment workflow

Claims status message enhancements: providing clear descriptions and actionable next steps

Authorization application enhancements: faster, easier, and more efficient

Submit digital attachments within seven calendar days for claims filed with a PWK segment indicator

You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too

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

Visit the Provider Learning Hub to view our latest learning opportunities

Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements

Coming soon: Anthem Provider Learning Hub makes Availity learning easier

Enhancing Provider News website and email communications

Simplifying requests for additional information

Enhancements to the Availity Authorization application are now available

How to enroll in electronic fund transfer (EFT) for faster remittance

Procedure searches in Find Care

New! Schedule appointments online through Availity

Submitting prior authorizations is getting easier

Digital Provider Enrollment Application available for providers who do not use CAQH

Anthem’s Provider Experience Model

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

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Submitting prior authorizations is getting easier

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

Is prior authorization required?

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

Reminder: EnrollSafe is available

Performance enhancements to the authorization application on Availity Essentials

Introducing the Provider Learning Hub

Two great learning resources on one secure portal

Add supporting documents directly to your claims with the new Claims Status Inquiry Send Attachments feature

Digital solution options with Availity

Submit EDI corrected claims via Availity or EDI

Anthem is transitioning to the Availity Authorization App

Good news! Non-payment remittance advice enhancements coming soon

Procedure searches in Find Care

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

Reminder: EnrollSafe replacing CAQH Enrollhub effective November 1, 2021

Anthem to acquire Beacon Health Options

Register for upcoming CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

5 Strategies to Improve Your Quality Measures - June 10^th, 12 p.m. or 3 p.m. ET
7 Ways to Enhance Your Patients’ Experience - June 17^th, 12 p.m. or 3 p.m. ET

Register now!

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

Telephonic-only care allowance extended through April 11, 2023

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

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

Sign up today for provider eUpdates

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

Additional changes to anthem.com to launch in March

Provider Manual updated effective July 1, 2022

Notices of material changes/amendments to contract - September 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:

• Reimbursement policy update:  Modifier Rules – Professional
• Specialty pharmacy updates - September 2022
• Clinical criteria updates for specialty pharmacy

Notices of material changes/amendments to contract - October 2022

• Precertification list changes effective January 1, 2023
• Clinical Criteria updates for specialty pharmacy
• Specialty pharmacy updates - October 2022
• Reimbursement policy update: Multiple and Bilateral Surgery Processing – Professional

Monkeypox and smallpox vaccines: Product code on claims

Commercial Risk Adjustment Program update: Medical chart collection for ACA members due March 31, 2019

Anthem acquires Beacon Health Options

A special thank you to Care Providers

Precertification list changes effective January 1, 2023

Continuing to Explore the Intersection of Race and Disability

National Accounts 2023 Pre-certification list

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Important information about women’s preventive care visits

Important reminder: New ID cards for many of our Anthem Blue Cross and Blue Shield members

Outpatient/office physical, speech, and occupational therapy claim form requirements

Anthem to accept Hospital in Home services

CAA: Review your online provider directory information

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

Digital Provider Enrollment application now available

Drug code billing reminder

Explore updates to medical attachment tool

Patient360 adds care gap alert feedback for medical providers

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

System upgrade billing requirements special notice

Submit claims with complete and correct data to avoid claim denials

EDI Gateway migration updates

Update on processing delays for provider applications and provider maintenance forms

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

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. 

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

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

Alcohol use disorder has a big cost

Well-child visits: Know the numbers

Resources to support diverse patients and communities

HEDIS® 2019: Controlling High Blood Pressure

Coding tips for reporting administration of Spravato®

CAA: Timely updates help keep our provider directories current

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

You are invited: Advancing Mental Health Equity for Youth & Young Adults

Primary care appointment access and open panels

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

Notices of material changes/amendments to contract - March 2023

Clinical practice and preventive health guidelines available on anthem.com

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

Coordination of care

Case management program

Important information about utilization management

Anthem and Quest Diagnostics form strategic relationship

Update to facility editing: HCPCS code G0463

Access to claim denial information is now self-service

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