Maine
Provider Communications

Articles

Title Publication Category Date

State of Maine employer group benefits for lab and imaging services

August 2018 Anthem Maine Provider Newsletter State Health Benefit Plan Aug 1, 2018

Blood pressure cuff benefits available effective July 1, 2018 for State of Maine employer group members

August 2018 Anthem Maine Provider Newsletter State Health Benefit Plan Aug 1, 2018

State of Maine Health Insurance Plan incents members to seek bariatric and hip/knee procedures at Centers of Excellence

March 2019 Anthem Maine Provider Newsletter State Health Benefit Plan Mar 1, 2019

State of Maine Health Plan benefits for blood pressure cuffs

May 2019 Anthem Maine Provider Newsletter State & Federal May 1, 2019

Diagnosis-Related Group Newborn Inpatient Stays facility reimbursement policy update

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

Cervical Cancer Screening using Cytology and Human Papillomavirus Testing (CG-MED-43) not implemented

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

Review of reimbursement policies – professional

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

Durable Medical Equipment professional reimbursement policy reminders

June 2018 Maine newsletter Reimbursement Policies Jun 22, 2018

Bundled Services and Supplies - professional

August 2018 Anthem Maine Provider Newsletter Reimbursement Policies Aug 1, 2018

Once per Lifetime Procedures - professional

August 2018 Anthem Maine Provider Newsletter Reimbursement Policies Aug 1, 2018

Claims requiring additional documentation facility reimbursement policy update

September 2018 Anthem Maine Network eUpdate Reimbursement Policies Aug 30, 2018

Assistant Surgeon Coding update: professional

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Documentation and Reporting Guidelines for E/M Services update: professional

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Routine Obstetrical Services update: professional

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Multiple Diagnostic Imaging Reimbursement Policy update: facility

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Readmissions Reimbursement Policy update: facility

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

New Facility Revenue Code Billing Reimbursement Policy

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Bundled Services and Supplies: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement for convenience surgical supply kits: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Scope of License reimbursement policy update: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

System updates for 2019: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional during the Postoperative Period: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Benefits to be available for chronic care management and advance care planning services effective February 23, 2019

January 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jan 1, 2019

Injectable Substances with Related Injection Services reimbursement policy update: professional

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019

Body Mass Index reimbursement policy: facility

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019

Significant Edits: professional

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019

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 Reimbursement Policies Apr 1, 2019

New Partial Hospitalization Program and Intensive Outpatient Program Services Facility Reimbursement Policy

April 2019 Anthem Maine Provider Newsletter Reimbursement Policies Apr 1, 2019

Drug Screen Testing update: professional

May 2019 Anthem Maine Provider Newsletter Reimbursement Policies May 1, 2019

New Reimbursement Policy - Ambulance Transportation - professional

June 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jun 1, 2019

Frequency Editing - professional

June 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jun 1, 2019

Bundled Services Reimbursement Policy update - professional

August 2019 Anthem Maine Provider News Reimbursement Policies Aug 1, 2019

Frequency Editing Reimbursement Policy update - professional

August 2019 Anthem Maine Provider News Reimbursement Policies Aug 1, 2019

New Reimbursement Policies - Maternity Services and Multiple Delivery - professional

September 2019 Anthem Maine Provider News Reimbursement Policies Sep 1, 2019

New Reimbursement Policy - Intensity Modulated Radiation Therapy Planning and Delivery - professional

September 2019 Anthem Maine Provider News Reimbursement Policies Sep 1, 2019

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Maine Provider News Reimbursement Policies Sep 1, 2019

Reimbursement Policy update - Place of Service – professional

October 2019 Anthem Maine Provider News Reimbursement Policies Oct 1, 2019

Reimbursement policy update: Claims Requiring Additional Documentation (facility)

May 2020 Anthem Maine Provider News Reimbursement Policies May 1, 2020

New Reimbursement Policy - Nurse Practitioner and Physician Assistant Services - professional

June 2020 Anthem Maine Provider News Reimbursement Policies Jun 1, 2020

Reimbursement policy update - Claims Requiring Additional Documentation (facility)

August 2020 Anthem Maine Provider News Reimbursement Policies Aug 1, 2020

Reimbursement policy update: Distinct Procedural Services - Modifiers 59, XE, XP, XS, XU - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Frequency Editing - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement policy update - Emergency Department: Leveling of Evaluation and Management Services (facility)

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and Venipuncture - professional

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Reimbursement policy update - Claims Requiring Additional Documentation policy (facility)

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Bundled Services and Supplies - professional

December 2020 Anthem Maine Provider News Reimbursement Policies Dec 1, 2020

Reimbursement policy update: Multiple Diagnostic Imaging Procedures - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency Editing - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit Frequency Maximum for Drugs and Biologicals - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility

February 2021 Anthem Maine Provider News Reimbursement Policies Feb 1, 2021

New reimbursement policy: Clinic Charges - facility

April 2021 Anthem Maine Provider News Reimbursement Policies Apr 1, 2021

Reimbursement policy reminder: Readmission - facility

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency Editing - professional

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - facility

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

AIM Musculoskeletal Program Clinical Appropriateness Guidelines updates

June 2018 Maine newsletter Products & Programs Jun 19, 2018

Individualized Care Program to support palliative care for commercial members

June 2018 Maine newsletter Products & Programs Jun 19, 2018

Easter Seals relationship expanded to support commercial members with complex needs

June 2018 Maine newsletter Products & Programs Jun 22, 2018

AIM Radiation Oncology Clinical Appropriateness Guidelines updates

August 2018 Anthem Maine Provider Newsletter Products & Programs Aug 1, 2018

AIM Advanced Imaging Clinical Appropriateness Guidelines updates

August 2018 Anthem Maine Provider Newsletter Products & Programs Aug 1, 2018

AIM Level of Care Musculoskeletal Surgery Clinical Appropriateness Guidelines updates

August 2018 Anthem Maine Provider Newsletter Products & Programs Aug 1, 2018

Additional support available for members with rare conditions

August 2018 Anthem Maine Provider Newsletter Products & Programs Aug 1, 2018

New pre-service clinical review requirement for EGD services begins November 1, 2018

August 2018 Anthem Maine Provider Newsletter Products & Programs Aug 1, 2018

AIM Specialty Health radiation oncology clinical guidelines updates

October 2018 Anthem Maine Provider Newsletter Products & Programs Oct 1, 2018

AIM Specialty Health clinical guidelines update: advanced imaging of the heart

October 2018 Anthem Maine Provider Newsletter Products & Programs Oct 1, 2018

AIM Specialty Health sleep disorder management clinical guidelines update

October 2018 Anthem Maine Provider Newsletter Products & Programs Oct 1, 2018

Anthem fights opioid addiction

October 2018 Anthem Maine Provider Newsletter Products & Programs Oct 1, 2018

Update to AIM Clinical Appropriateness Guidelines

December 2018 Anthem Maine Provider Newsletter Products & Programs Dec 1, 2018

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

December 2018 Anthem Maine Provider Newsletter Products & Programs Dec 1, 2018

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

December 2018 Anthem Maine Provider Newsletter Products & Programs Dec 1, 2018

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

February 2019 Anthem Maine Provider Newsletter Products & Programs Feb 1, 2019

New AIM Rehabilitative program effective July 1, 2019

April 2019 Anthem Maine Provider Newsletter Products & Programs Apr 1, 2019

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline

April 2019 Anthem Maine Provider Newsletter Products & Programs Apr 1, 2019

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines

April 2019 Anthem Maine Provider Newsletter Products & Programs Apr 1, 2019

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines

April 2019 Anthem Maine Provider Newsletter Products & Programs Apr 1, 2019

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Maine Provider Newsletter Products & Programs Jun 1, 2019

AIM programs may require additional prior authorization documentation

June 2019 Anthem Maine Provider Newsletter Products & Programs Jun 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

July 2019 Anthem Maine Provider News Products & Programs Jul 1, 2019

UPDATE: new Rehabilitative Program now effective August 1, 2019

Maine - July UPDATE: New Rehabilitative Program Now Effective August 1, 2019 Products & Programs Jul 3, 2019

UPDATE: new Rehabilitative Program remains temporarily delayed

Maine - UPDATE: New Rehabilitative Program Remains Temporarily Delayed Products & Programs Jul 16, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

August 2019 Anthem Maine Provider News Products & Programs Aug 1, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Maine Provider News Products & Programs Aug 1, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Maine Provider News Products & Programs Aug 1, 2019

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

October 2019 Anthem Maine Provider News Products & Programs Oct 1, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guidelines

November 2019 Anthem Maine Provider News Products & Programs Nov 1, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

November 2019 Anthem Maine Provider News Products & Programs Nov 1, 2019

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

November 2019 Anthem Maine Provider News Products & Programs Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

November 2019 Anthem Maine Provider News Products & Programs Nov 1, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Maine Provider News Products & Programs Dec 1, 2019

New musculoskeletal and pain management solution effective for select National ASO accounts January 1, 2020

January 2020 Anthem Maine Provider News Products & Programs Jan 1, 2020

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

February 2020 Anthem Maine Provider News Products & Programs Feb 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

February 2020 Anthem Maine Provider News Products & Programs Feb 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Maine Provider News Products & Programs May 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

June 2020 Anthem Maine Provider News Products & Programs Jun 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

July 2020 Anthem Maine Provider News Products & Programs Jul 1, 2020
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