Missouri
Provider Communications

December 2018 Anthem Missouri Provider Newsletter

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Title	Category
2019 FEP Benefit information available online	Federal Employee Plan (FEP)
2019 Medicare Advantage individual benefits and formularies	Medicare
Anthem Accepts Electronic Prior Authorization Requests for Prescription Medications Online	Pharmacy
Anthem Streamlines Member ID Cards - Use Availity to Verify Members' Cost Shares and Benefits at Time of Service	Administrative
Anthem to Enhance Claim Edits for Outpatient Facility Claims	Administrative
Anthem Works to Simplify Payment Recovery Process for National Accounts Membership	Administrative
Availity to Serve as EDI Entry Point for Electronic Submissions	Administrative
Benefit change for Infliximab for Federal Employee Program (FEP)	Federal Employee Plan (FEP)
Bundled Services and Supplies (Professional)	Reimbursement Policies
Case Management Program	Administrative
Clinical practice and preventive health guidelines available on anthem.com	Medical Policy & Clinical Guidelines
CMS Medicare Preclusion List effective April 1, 2019	Medicare
ConditionCare Program Benefits Patients and Physicians	Administrative
Coordination of Benefits for an FEP® member	Federal Employee Plan (FEP)
Coordination of Care	Administrative
HEDIS® 2018 Commercial Results Are In	Administrative
Important Information about Utilization Management	Administrative
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019	Medicare
Integrated Care Model for Plans Purchased on the Health Insurance Marketplace Benefits Patients and Physicians	Administrative
Interactive Care Reviewer (ICR) New Features	Coverage and Clinical Guidelines
Introducing the New Clinical Criteria Page for Injectable, Infused or Implanted Drugs	Pharmacy
Keep up with Medicare news	Medicare
Medical Polices and Clinical Guidelines Updates - December 2018	Medical Policy & Clinical Guidelines
Medicare Part B drugs may include Step Therapy beginning January 1, 2019	Medicare
Members’ Rights and Responsibilities	Administrative
New Medicare Advantage provider service phone number beginning January 1, 2019	Medicare
Pharmacy Information Available at anthem.com	Pharmacy
Reimbursement for Convenience Surgical Supply Kits: Professional	Reimbursement Policies
Reimbursement Policy Update - Scope of License (Professional)	Reimbursement Policies
Reimbursement Policy Updates - December 2018	Reimbursement Policies
Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines	Coverage and Clinical Guidelines
Update to AIM Clinical Appropriateness Guidelines	Coverage and Clinical Guidelines
Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines	Coverage and Clinical Guidelines
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web	Administrative
View reimbursement policies online at anthem.com	Reimbursement Policies
When and how to initiate Medicare Advantage reopenings	Medicare

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem websites constitutes your agreement with our Terms of Use.