Maine
Provider Communications

Articles

Title Publication Category Date

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

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

November 2019 Anthem Maine Provider News Pharmacy Nov 1, 2019

Pre-service clinical review and quantity limit updates for specialty pharmacy effective February 1, 2020

November 2019 Anthem Maine Provider News Pharmacy Nov 1, 2019

Clinical criteria updates for specialty pharmacy

November 2019 Anthem Maine Provider News Pharmacy Nov 1, 2019

Additional improvements coming to anthem.com

November 2019 Anthem Maine Provider News Administrative Nov 1, 2019

Reminder: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Maine Provider News Administrative Nov 1, 2019

Appropriate coding helps provide a comprehensive picture of patients’ health

November 2019 Anthem Maine Provider News Administrative Nov 1, 2019

Medical policy updates are available on anthem.com

November 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

Clinical guideline updates are available on anthem.com

November 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

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

Bill Medicare Part D for shingles or tetanus vaccination claims

November 2019 Anthem Maine Provider News Medicare Nov 1, 2019

Modifier use reminders

November 2019 Anthem Maine Provider News Administrative Nov 1, 2019

Enhanced search and download options allow easy access to information at your fingertips

Enhanced search and download options allow easy access to information at your fingertips - Maine Administrative Oct 8, 2019

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

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

Specialty pharmacy medical step therapy drug list clarification

October 2019 Anthem Maine Provider News Pharmacy Oct 1, 2019

Important update to Anthem’s commercial drug lists

October 2019 Anthem Maine Provider News Pharmacy Oct 1, 2019

Pharmacy information available on anthem.com

October 2019 Anthem Maine Provider News Pharmacy Oct 1, 2019

Sign up today for provider eUpdates

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

Additional changes launched to anthem.com

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

U.S. Antibiotic Awareness Week November 11-18

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

National Accounts 2020 precertification list

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program continues

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

Matrix to provide mobile health clinic assessments to ACA members

October 2019 Anthem Maine Provider News Administrative Oct 1, 2019

Reimbursement Policy update - Place of Service – professional

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

Federal Employee Program® specialty pharmacy clinical site-of-care prior authorization review

October 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Oct 1, 2019

Precertification request turnaround times for the Federal Employee Program

October 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Aspire Health telephonic palliative care program for Medicare members

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Medical drug clinical criteria updates

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Clinical laboratory improvement amendments

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Lowering health risks with no-cost statins

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Prior authorization requirements for continuous positive airway pressure supplies

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Assisting your patients in managing the Donut Hole

October 2019 Anthem Maine Provider News Medicare Oct 1, 2019

Clinical criteria updates

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

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

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

Access requirements for behavioral healthcare services

September 2019 Anthem Maine Provider News Behavioral Health Sep 1, 2019

Clinical criteria updates for specialty pharmacy

September 2019 Anthem Maine Provider News Pharmacy Sep 1, 2019

Specialty pharmacy prior authorization list to be expanded effective December 1, 2019

September 2019 Anthem Maine Provider News Pharmacy Sep 1, 2019

Anthem launches Sydney on September 1; new app offers better digital health care support to members

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Controlling high blood pressure

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Provider transparency update

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Appointment access standards for primary care, specialty care and behavioral health practitioners

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

PCP after-hours access requirements

September 2019 Anthem Maine Provider News Administrative Sep 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

Claim editing update for Excludes1 notes

September 2019 Anthem Maine Provider News Administrative Sep 1, 2019

Medical policy updates are available on anthem.com

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

Clinical guideline updates are available on anthem.com

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

New Clinical Guideline: Pneumatic Compression Devices effective December 1, 2019

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

Electronic attachments coming soon

September 2019 Anthem Maine Provider News Medicare Sep 1, 2019

MaineHealth and Anthem Blue Cross and Blue Shield launch joint venture

N/A Administrative Aug 19, 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

Specialty pharmacy pre-service clinical review list expanded effective November 1, 2019

August 2019 Anthem Maine Provider News Pharmacy Aug 1, 2019

Reminder: Process change for medical non-oncology specialty drug reviews effective June 15, 2019

August 2019 Anthem Maine Provider News Pharmacy Aug 1, 2019

Pharmacy information available on anthem.com

August 2019 Anthem Maine Provider News Pharmacy Aug 1, 2019

Anthem customizations to MCG care guidelines 23rd edition

August 2019 Anthem Maine Provider News Administrative Aug 1, 2019

Streamlined access to Anthem Provider Manual

August 2019 Anthem Maine Provider News Administrative Aug 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

Medical policy updates are available on anthem.com

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Clinical guideline updates are available on anthem.com

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Clinical criteria updates for specialty pharmacy

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Keep up with Medicare news

August 2019 Anthem Maine Provider News Medicare Aug 1, 2019

New service types added to Availity

August 2019 Anthem Maine Provider News Medicare Aug 1, 2019

New reimbursement policy effective October 1, 2019 - Drug Screen Testing

August 2019 Anthem Maine Provider News Medicare Aug 1, 2019

Special needs plans - provider training required

August 2019 Anthem Maine Provider News Medicare Aug 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Anthem Maine Provider News Medicare Aug 1, 2019

UPDATE: new Rehabilitative Program remains temporarily delayed

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

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

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

Clinical criteria updates for specialty pharmacy

July 2019 Anthem Maine Provider News Pharmacy Jul 1, 2019

Clinical criteria coding updates for specialty pharmacy

July 2019 Anthem Maine Provider News Pharmacy Jul 1, 2019

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

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Clinical validation - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Payment recovery process simplified for National Accounts membership

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Make the move to the Availity EDI Gateway today

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

State-supplied vaccines reminder - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Modifier 79 reminder - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

Modifier 63 reminder - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019

ICD-10-CM coding guidelines and laterality - professional

July 2019 Anthem Maine Provider News Administrative Jul 1, 2019
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