Maine
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

Update: Notice of changes to the AIM musculoskeletal program

September 2020 Anthem Maine Provider News Medicare Sep 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Maine Provider News Medicare Nov 1, 2020

Clinical criteria updates

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Keep up with Medicare news

September 2020 Anthem Maine Provider News Medicare Sep 1, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Changes to prior authorization requirements effective December 1, 2019

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Keep up with Medicare news

November 2020 Anthem Maine Provider News Medicare Nov 1, 2020

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Keep up with Medicare news

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

Keep up with Medicare news

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

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

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

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Maine Provider News Medicare Nov 1, 2021

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

July 2021 Maine Provider News Medicare Jul 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

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

Keep up with Medicare news

July 2021 Maine Provider News Medicare Jul 1, 2021

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

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

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

Dual eligible special needs plans: provider training required

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

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

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

2023 Medicare Advantage service area and benefit updates

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

Personal home helper benefit ending

December 2022 Provider Newsletter - Maine Medicare Dec 1, 2022

Keep up with Medicare news

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Provider Newsletter - Maine Medicare Dec 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

Enhancing claims attachment processes through digital applications

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

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

January 2022 Anthem Maine Provider News Medicare Jan 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Keep up with Medicare news

January 2022 Anthem Maine Provider News Medicare Jan 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

Medical drug benefit clinical criteria updates

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

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

May 2022 Anthem Maine Provider News Medicare May 1, 2022

New MCG Care Guidelines 24th edition

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

HEDIS 2022: summary of changes from NCQA

May 2022 Anthem Maine Provider News Medicare May 1, 2022

AMH Health LLC. expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AIM Musculoskeletal Program expansion

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

New specialty pharmacy medical step therapy requirements

May 2022 Anthem Maine Provider News Medicare May 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

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

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

Keep up with Medicare news

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

Updated COVID-19 Medicare Information

COVID-19 Information - Maine Medicare Apr 20, 2020

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

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
February 2023 Provider Newsletter - Maine Medicare Feb 1, 2023

AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.

February 2023 Provider Newsletter - Maine Medicare Feb 1, 2023

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

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Electronic claim payment reconsideration

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Medical policies and clinical utilization management guidelines update

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Keep up with Medicare news

Please continue to check Important Medicare Advantage Updates for the latest Medicare Advantage information, including:
January 2023 Provider Newsletter - Maine Medicare Dec 30, 2022

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Engagement with your patient counts

January 2023 Provider Newsletter - Maine Medicare Dec 30, 2022

Home health billing guidelines for contracted providers

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

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

Attention lab providers: COVID-19 update regarding reimbursement

January 2023 Provider Newsletter - Maine Medicare Dec 30, 2022

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Keep up with Medicare news

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Medical drug benefit clinical criteria updates

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

Cancer Care Navigator

July 2022 Anthem Maine Provider News Medicare Jul 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

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

Modifier 62 policy update: Co-Surgeons

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

2021 Medicare Advantage individual benefits and formularies

December 2020 Anthem Maine Provider News Medicare Dec 1, 2020

Medicare Advantage Group Retiree member eligibility, alpha prefix FAQs

December 2020 Anthem Maine Provider News Medicare Dec 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Keep up with Medicare news

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

Cologuard covered for Medicare Advantage members

June 2018 Maine newsletter Medicare Jun 19, 2018

Medicare preferred continuous glucose monitors

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medical policies and clinical utilization management guidelines update applicable to Anthem and AMH Health, LLC.

December 2020 Anthem Maine Provider News Medicare Dec 1, 2020

Peer-to-peer process can help clarify clinical record

June 2018 Maine newsletter Medicare Jun 19, 2018

Medical drug benefit clinical criteria updates - August 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Maine Provider News Medicare Dec 1, 2020

MA home health network to be delegated to myNEXUS

June 2018 Maine newsletter Medicare Jun 19, 2018

Medical drug benefit clinical criteria updates - September 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medication adherence incentive offered to EPHC providers

June 2018 Maine newsletter Medicare Jun 19, 2018

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Keep up with Medicare news

December 2020 Anthem Maine Provider News Medicare Dec 1, 2020

Motion Picture Industry Pension and Health Plans Offers Medicare Advantage Option

June 2018 Maine newsletter Medicare Jun 19, 2018

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020
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