Missouri
Provider Communications

January 2023 Anthem Provider News - Missouri

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Title Category

Professional system updates for 2023

Administrative

Outpatient system updates for 2023

Administrative

Notification regarding reimbursement changes to COVID-19 laboratory services codes

Administrative

Engagement with your patient counts

Administrative

Childhood Immunization Status and Lead Screening in Children for HEDIS

Administrative

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

Administrative

Submitting prior authorizations digitally through Interactive Care Reviewer

Digital Tools

Outpatient facility revenue code billing requirements

Reimbursement Policies

Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

Medical Policy & Clinical Guidelines

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update

Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines - Material adverse change

Medical Policy & Clinical Guidelines

Specialty pharmacy updates

Pharmacy

Keep up with Medicare news - January 2023

- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
Medicare

Cleveland-Cliffs offers Medicare Advantage option

Medicare

Federal Employee Program observation conversion for musculoskeletal cases

Federal Employee Plan (FEP)
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