Maine
Provider Communications

Articles

Title Publication Category Date

Provider Manual to be updated July 1, 2020

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Continued focus on updates to public provider website

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

Provider transparency update

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical records request requirements

April 2020 Anthem Maine Provider News Administrative Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Medical drug benefit clinical criteria updates - November 2019

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Medical drug benefit clinical criteria updates - December 2019

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Keep up with Medicare news

April 2020 Anthem Maine Provider News Medicare Apr 1, 2020

Anthem acquires Beacon Health Options

N/A Administrative Mar 2, 2020

Clinical criteria updates for specialty pharmacy

March 2020 Anthem Maine Provider News Pharmacy Mar 1, 2020

Pharmacy information available on anthem.com

March 2020 Anthem Maine Provider News Pharmacy Mar 1, 2020

New enhancements with Provider News

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Reminder: non-physical, occupational or speech therapists must include modifiers on physical, occupational, or speech therapy claims

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Patient360 enhancement for medical providers

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Commercial Risk Adjustment (CRA) Program update: Medical chart collection for ACA members due March 31, 2020

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Modifier use reminders

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Important coding reminder for Walk-in Retail Health Clinics

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Provider Maintenance Form (PMF) enhancement

March 2020 Anthem Maine Provider News Administrative Mar 1, 2020

Clinical guideline update effective June 1, 2020 - Paraesophageal Hernia Repair

March 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Mar 1, 2020

Keep up with Medicare news

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

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

March 2020 Anthem Maine Provider News Medicare Mar 1, 2020

Non-preferred products and corresponding preferred alternatives

March 2020 Anthem Maine Provider News Medicare Mar 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

Behavioral health outpatient visits for 2020

February 2020 Anthem Maine Provider News Behavioral Health Feb 1, 2020

Formulary lists updated for commercial health plans

February 2020 Anthem Maine Provider News Pharmacy Feb 1, 2020

Clinical criteria updates for specialty pharmacy

February 2020 Anthem Maine Provider News Pharmacy Feb 1, 2020

CLIA claim requirements effective May 1, 2020

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

Shine Light on Depression school-based suicide prevention initiative

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

SOAP Notes Health Assessments for 2019 calendar year due February 15, 2020

February 2020 Anthem Maine Provider News Administrative Feb 1, 2020

Medical policy updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical guideline updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

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

Keep up with Medicare news

February 2020 Anthem Maine Provider News Medicare Feb 1, 2020

Many Anthem members received new ID numbers effective January 1, 2020

Many Anthem members received new ID numbers effective January 1, 2020 - Maine Administrative Jan 9, 2020

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

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

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Outpatient facility edit implementation effective April 26, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Important update: Milliman Care Guideline (MCG), 23rd Edition, Pelvic Organ Prolapse Repair

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Upcoming retirement planned for legacy medical attachment submission tool

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Let us help you accomplish your 2020 “To Do” list early - EDI migration

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

New Year brings new ID cards for many Anthem members

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Sign up today for provider eUpdates

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

2020 FEP® benefit information available online

January 2020 Anthem Maine Provider News Administrative Jan 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medicare preferred continuous glucose monitors

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medical drug benefit clinical criteria updates - August 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Medical drug benefit clinical criteria updates - September 2019

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Maine Provider News Medicare Jan 1, 2020

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

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

Reminder: New AIM Rehabilitative Program effective November 1, 2019

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

Coding reminder for psychological and neuropsychological testing

December 2019 Anthem Maine Provider News Behavioral Health Dec 1, 2019

Clinical criteria updates for specialty pharmacy

December 2019 Anthem Maine Provider News Pharmacy Dec 1, 2019

Pharmacy information available on anthem.com

December 2019 Anthem Maine Provider News Pharmacy Dec 1, 2019

Retrieve Anthem member HEDIS® care gaps through Patient360 on the Availity Portal

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

System updates for 2020 - professional

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Payment recovery process simplified for National Accounts membership

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

National Consumer Cost Tool (NCCT) provider cost data available for review

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Case Management Program

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Coordination of care

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Important information about utilization management

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Members’ Rights and Responsibilities

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

New Reimbursement Policies: Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers - professional

December 2019 Anthem Maine Provider News Administrative Dec 1, 2019

Coordination of benefits for an FEP® member

December 2019 Anthem Maine Provider News Federal Employee Plan (FEP) Dec 1, 2019

2020 Medicare Advantage individual benefits and formularies

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

CMS reminder: expedited/urgent requests

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Group Retiree PPO plans

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Global 3M19 Medical Policy and Technology Assessment Committee prior authorization updates

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Prior authorization requirements for E0784, K0553 and K0554

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Electronic data interchange

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Anthem | MaineHealth to offer three new health maintenance organizations in 2020

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Introducing Interactive Care Reviewer

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

AMH Health, LLC (Anthem | MaineHealth) reimbursement policies

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Medical drug clinical criteria updates

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

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

December 2019 Anthem Maine Provider News Medicare Dec 1, 2019

Reminder: refer Medicare Advantage members to in-network providers

December 2019 Anthem Maine Provider News Medicare Dec 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

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

Modifier use reminders

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
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