Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

 

Clinical Guidelines

  • Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

 

Reimbursement

  • Clinical Validation: Professional*
  • Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*

 

Other Important Updates

  • Pharmacy: Clinical criteria updates for specialty pharmacy
  • FEP: Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

 

Medicare and Medicaid News

 



Featured In:
July 2019 Anthem Provider News - Missouri