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

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

Keep up with Medicare news

July 2021 Maine Provider News Medicare Jul 1, 2021

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

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

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

Keep up with Medicare news

March 2019 Anthem Maine Provider Newsletter Medicare Mar 1, 2019

Medical drug benefit clinical criteria updates

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

New MCG Care Guidelines 24th edition

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

AIM Musculoskeletal Program expansion

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Maine Provider News Medicare Aug 1, 2020

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

Electronic claim payment reconsideration

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

Home health billing guidelines for contracted providers

July 2019 Anthem Maine Provider News Medicare Jul 1, 2019

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

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

Keep up with Medicare news

June 2018 Maine newsletter Medicare Jun 19, 2018

Postponed - review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Keep up with Medicare news

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Modifier use reminders

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

Optum to collect medical records for risk adjustment

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

Risk adjustment and documentation training offered

January 2019 Anthem Maine Provider Newsletter Medicare Jan 1, 2019

Reminder: Anthem follows Original Medicare policies

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Maine Provider Newsletter Medicare Jan 1, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Diabetes HbA1c HEDIS guidance

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

Keep up with Medicare news

January 2019 Anthem Maine Provider Newsletter Medicare Jan 1, 2019

Eye refraction and routine eye exam billing information

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

New specialty Medicare Part B device preferred product program

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

February 2019 Anthem Maine Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

June 2020 Anthem Maine Provider News Medicare Jun 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

New provider directory indicator for telehealth services

March 2021 Anthem Maine Provider News Medicare Mar 1, 2021

In-office assessment program

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

Prior authorization for BiPAP equipment and supplies moving from AIM Specialty Health effective July 1, 2020

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

Maine Education Association Benefits Trust offers Medicare Advantage option

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

MA back pain management and cardiology UM programs to transition from OrthoNet to AIM

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Keep up with Medicare news

July 2020 Anthem Maine Provider News Medicare Jul 1, 2020

Please evaluate statin use for MA members with diabetes, cardiovascular disease

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Medicare pharmacy and prescriber home starts January 2019

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

April 2019 Anthem Maine Provider Newsletter Medicare Apr 1, 2019

Keep up with Medicare news

October 2018 Anthem Maine Provider Newsletter Medicare Oct 1, 2018

Reimbursement for select HEDIS related CPT II codes for Medicare Advantage members coming soon

April 2019 Anthem Maine Provider Newsletter Medicare Apr 1, 2019

Keep up with Medicare news

April 2019 Anthem Maine Provider Newsletter Medicare Apr 1, 2019

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

2019 Enhanced Personal Health Care Program releases myFHR

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Reimbursement Policy update: Drug Screen Testing

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Rehabilitative services prior authorization review update for Medicare Advantage members

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Bill Medicare Part D for shingles or tetanus vaccination claims

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Aspire Health telephonic palliative care program for Medicare members

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Medical drug benefit clinical criteria updates - November 2020

April 2021 Anthem Maine Provider News Medicare Apr 1, 2021

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Medical drug benefit clinical criteria updates - December 2020

April 2021 Anthem Maine Provider News Medicare Apr 1, 2021

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Outpatient Rehabilitation Program transition: new prior authorization requirements effective April 1, 2020

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

Medical drug benefit clinical criteria updates - November 2019

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020
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