Maine
Provider Communications

Articles

Title Publication Category Date

Monkeypox and smallpox vaccines: Product code on claims

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Precertification list changes effective January 1, 2023

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

National Accounts 2023 Pre-certification list

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

CAA: Review your online provider directory information

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

October 2022 Provider Newsletter – Maine Administrative Oct 1, 2022

Provider Learning Hub is here

October 2022 Provider Newsletter – Maine Digital Tools Oct 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Clinical Criteria updates for specialty pharmacy

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Specialty pharmacy updates - October 2022

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Pharmacy information available on provider website

October 2022 Provider Newsletter – Maine Pharmacy Oct 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

October 2022 Provider Newsletter – Maine Federal Employee Plan (FEP) Oct 1, 2022

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

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

Continuing to Explore the Intersection of Race and Disability

Continuing to Explore the Intersection of Race and Disability forum - Maine Administrative Sep 9, 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

 

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Anthem to accept Hospital in Home services

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Monkeypox resources and recommendations for our care providers

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Reimbursement policy update: Modifier Rules - Professional

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Specialty pharmacy updates - September 2022

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Maine Provider News Medicare Sep 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

AMH Health LLC. expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 1, 2022

AMH Health, LLC expands specialty pharmacy precertification list

September 2022 Anthem Maine Provider News Medicare Sep 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

Continuing to Explore the Intersection of Race and Disability

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Important information about women’s preventive care visits

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Drug code billing reminder

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

September 2022 Anthem Maine Provider News Administrative Sep 1, 2022

Updates to the Claim Attachment workflow

September 2022 Anthem Maine Provider News Digital Tools Sep 1, 2022

Update to formulary lists for Commercial health plan pharmacy benefit

September 2022 Anthem Maine Provider News Pharmacy Sep 1, 2022

New Back Pain Management Program

September 2022 Anthem Maine Provider News Products & Programs Sep 1, 2022

Specialty pharmacy updates

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Notices of material changes/amendments to contract - August 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: Place of Service - Facility
  • Medical policy and clinical guideline updates are available on anthem.com
  • Specialty pharmacy updates
  • Clinical criteria updates for specialty pharmacy
August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Performance enhancements to the authorization application on Availity Essentials

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Reimbursement policy update: Place of Service - Facility

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Reimbursement Policies Aug 1, 2022

Medical policy and clinical guideline updates are available on anthem.com

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2022

Pharmacy information available on anthem.com

August 2022 Anthem Maine Provider News Pharmacy Aug 1, 2022

Reminder: Inpatient/outpatient commercial claim denials

August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Timely updates help keep our provider directories current

August 2022 Anthem Maine Provider News Administrative Aug 1, 2022

Introducing the Provider Learning Hub

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Add supporting documents directly to your claims with the new Claims Status Inquiry Send Attachments feature

August 2022 Anthem Maine Provider News Digital Tools Aug 1, 2022

Telehealth visits can impact after-hospitalization follow-up care for mental illness

August 2022 Anthem Maine Provider News Behavioral Health Aug 1, 2022

Join us for our next clinical quality in practice webinar

Join us for our next clinical quality in practice webinar - Maine Administrative Jul 20, 2022

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

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
July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

Enhanced reimbursement for voluntary Cancer Care Quality Program to be discontinued effective December 31, 2022

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

Update to facility editing: HCPCS code G0463

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

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

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

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

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

Clearing up coding confusion for diabetic retinal screenings

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

CAA: Keep your provider directory information current

July 2022 Anthem Maine Provider News Administrative Jul 1, 2022

Enhancing claims attachment processes through digital applications: Add attachments through Claims Status Inquiry

July 2022 Anthem Maine Provider News Digital Tools Jul 1, 2022

Coming soon: Anthem Provider Learning Hub makes Availity learning easier

July 2022 Anthem Maine Provider News Digital Tools Jul 1, 2022

New reimbursement policy: Transitional Care Management - Professional

July 2022 Anthem Maine Provider News Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy - Sexually Transmitted Infections – Professional

July 2022 Anthem Maine Provider News Reimbursement Policies Jul 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of Material Change/Amendment to Contract
July 2022 Anthem Maine Provider News Pharmacy Jul 1, 2022

Pharmacy information available online

July 2022 Anthem Maine Provider News Pharmacy Jul 1, 2022

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

July 2022 Anthem Maine Provider News State Health Benefit Plan Jul 1, 2022

Cancer Care Navigator

July 2022 Anthem Maine Provider News Medicare Jul 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

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

New Prior Authorization Requirements for State of Maine Health Plan Members Administrative Jun 20, 2022

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Elevance Health Administrative Jun 15, 2022

Exploring the Intersection of Race and Disability

Register today for a forum on Exploring the Intersection of Race and Disability hosted by Anthem Blue Cross and Blue Shield and Motivo* for Anthem providers on June 22, 2022.
Exploring the Intersection of Race and Disability forum - Maine Administrative Jun 8, 2022

Notices of material changes/amendments to contract - June 2022

June 2022 Anthem Maine Provider News Administrative Jun 1, 2022

Exploring the Intersection of Race and Disability forum

June 2022 Anthem Maine Provider News Administrative Jun 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (facility)

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Reimbursement Policies Jun 1, 2022

Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Updated AIM Musculoskeletal Program effective October 1, 2022

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Products & Programs Jun 1, 2022

Specialty pharmacy updates - June 2022

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Pharmacy Jun 1, 2022

Medical policies and clinical utilization management guidelines update

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

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

Medical drug benefit clinical criteria updates

June 2022 Anthem Maine Provider News Medicare Jun 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

Provider outreach to validate your provider data

June 2022 Anthem Maine Provider News Administrative Jun 1, 2022

Once-a-year testing is critically important to providing quality diabetes care

June 2022 Anthem Maine Provider News Administrative Jun 1, 2022

CAA: Provider directories accuracy is important

June 2022 Anthem Maine Provider News Administrative Jun 1, 2022

Opioid overdose deaths: What can we do?

June 2022 Anthem Maine Provider News Behavioral Health Jun 1, 2022

Process change for Federal Employee Program® third-party correspondence requests

June 2022 Anthem Maine Provider News Federal Employee Plan (FEP) Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Anthem Maine Provider News Medicare Jun 1, 2022

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
May 2022 Anthem Maine Provider News Administrative May 1, 2022

Provider Manual updated effective July 1, 2022

Notice of material change/amendment to contract
May 2022 Anthem Maine Provider News Administrative May 1, 2022

Primary care appointment access and open panels

May 2022 Anthem Maine Provider News Administrative May 1, 2022

Medical policy and clinical guideline updates available on anthem.com

Notice of material change/amendment to contract
May 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines May 1, 2022

Clinical criteria updates for specialty pharmacy

Notice of material change/amendment to contract
May 2022 Anthem Maine Provider News Pharmacy May 1, 2022

Specialty pharmacy updates - May 2022

Notice of material change/amendment to contract
May 2022 Anthem Maine Provider News Pharmacy May 1, 2022
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