Maine
Provider Communications

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

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

Notices of material changes/amendments to contract - November 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:

• Correction to reimbursement policy: Place of Service - Facility
• Medical policy and clinical guideline updates available on anthem.com
• Specialty pharmacy updates - November 2022

Coming soon - Interactive Care Reviewer Anthem’s self-service online prior authorization tool

Post office boxes being retired because of low usage

Reminder - New ID cards for many Anthem members

New! Vaccination resource page for providers

Support documentation for AIM prior authorization requests

Migrate your EDI transactions to Availity today

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

Anthem Waives Cost Share for COVID-19 Treatment (updated May 29, 2020)

Clinical Laboratory Improvement Amendments (CLIA) ID number required for electronic claims submissions

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

Clearing up coding confusion for diabetic retinal screenings

Electronic attachments - X12 275 5010

Anthem makes going digital easy with the Provider Digital Engagement Supplement

New policy for EMR clinical data sharing and ADT notifications

Information from Anthem for Care Providers about COVID-19 (updated November 8, 2022)

Prior Authorization/Referral Request and Inpatient Admission/Discharge Notification transactions coming soon

Updated preventive care guidance regarding screening colonoscopies

Medical record standards

Update on claims processing

Resources to support diverse patients and communities

CAA: Keep your provider directory information current

Appropriate coding helps provide a comprehensive picture of members’ health

Understanding your patients’ differences is lifesaving

Two-minute videos to engage patients about preventive care

Notices of material changes/amendments to contract - December 2022

Have you reviewed your online provider directory information lately?

Notices of material changes/amendments to contract - June 2022

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

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

Monkeypox resources and recommendations for our care providers

New ID cards for some Anthem members

Exploring the Intersection of Race and Disability forum

CAA: Keep your provider directory information up to date

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services - RETIRED as of November 8, 2022

As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED.
Future updates regarding COVID-19 will appear in the monthly Provider News publication.

Continuing to Explore the Intersection of Race and Disability

Update to provider/facility UM reimbursement penalties and corresponding update to Provider/Facility Manual

Clinical validation - professional