Missouri
Provider Communications

Articles

Title Publication Category Date

Information from Anthem for Care Providers about COVID-19 (Updated September 18, 2020)

We recently updated FAQs about cost share waivers for telehealth and telephonic-only care.
COVID-19 Information - Missouri Administrative Sep 18, 2020

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020

September 2020 Anthem Provider News - Missouri Products & Programs Sep 1, 2020

Meet your Cancer Care Navigator

Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.
September 2020 Anthem Provider News - Missouri Products & Programs Sep 1, 2020

Predictive analytics guide proactive support to patients undergoing chemotherapy resulting in lowered admissions

September 2020 Anthem Provider News - Missouri Products & Programs Sep 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

September 2020 Anthem Provider News - Missouri Pharmacy Sep 1, 2020

Specialty pharmacy updates are available - September 2020

September 2020 Anthem Provider News - Missouri Pharmacy Sep 1, 2020

New provider directory indicators for medication assisted treatment (MAT) providers

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

The 2020 Provider Manual is now available*

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Eye exam benefit for St. Louis police

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

EDI Gateway migration deadline is September 15, 2020

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Providers can now receive and respond to medical record requests for post-pay audit via Change Healthcare’s Assurance Attach Assist Module

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Enhanced medical records submission process to support claims processing

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Patient360 adds care gap alert feedback for medical providers

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program continues

September 2020 Anthem Provider News - Missouri Administrative Sep 1, 2020

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)

September 2020 Anthem Provider News - Missouri Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Frequency Editing (Professional)

September 2020 Anthem Provider News - Missouri Reimbursement Policies Sep 1, 2020

Update: Notice of changes to the AIM musculoskeletal program

September 2020 Anthem Provider News - Missouri Medicare Sep 1, 2020

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Missouri Medicare Sep 1, 2020

IUOE 513 Welfare Fund moves to Anthem Medicare Preferred (PPO) medical plan

September 2020 Anthem Provider News - Missouri Medicare Sep 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News - Missouri Pharmacy Aug 1, 2020

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

August 2020 Anthem Provider News - Missouri Pharmacy Aug 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - August 2020

August 2020 Anthem Provider News - Missouri Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News - Missouri Pharmacy Aug 1, 2020

Provider contract and fee schedule notifications coming soon

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Evaluation and management services correct coding (Professional)

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Migrate your EDI transactions to Availity today

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Electronic claims submission - Clinical Laboratory Improvement Amendments (CLIA)

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Anthem electronic attachments - X12 275 5010

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Medical record standards

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Anthem Provider News - Missouri Administrative Aug 1, 2020

Medical policy and clinical guideline updates - August 2020

August 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Aug 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020

August 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)

August 2020 Anthem Provider News - Missouri Reimbursement Policies Aug 1, 2020

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News - Missouri Medicare Aug 1, 2020

2019 Commercial member satisfaction with behavioral health care and services survey results

July 2020 Anthem Provider News - Missouri Behavioral Health Jul 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Missouri Products & Programs Jul 1, 2020

Updated coverage for HIV PrEP medications

July 2020 Anthem Provider News - Missouri Pharmacy Jul 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - July 2020

July 2020 Anthem Provider News - Missouri Pharmacy Jul 1, 2020

Important change to prior authorization requests for inpatient hospital admissions

July 2020 Anthem Provider News - Missouri Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News - Missouri Administrative Jul 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

July 2020 Anthem Provider News - Missouri Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Jul 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determination

July 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Jul 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News - Missouri Federal Employee Plan (FEP) Jul 1, 2020

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

2020 affirmative statement concerning utilization management decisions

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

In-Office Assessment Program

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News - Missouri Medicare Jul 1, 2020

Webinar recording now available for providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Missouri Behavioral Health Jun 25, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated June 9, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Missouri Administrative Jun 9, 2020

Reminder: Anthem requires National Drug Code for professional and facility outpatient claims effective June 15, 2020

June 2020 Anthem Provider News - Missouri Pharmacy Jun 1, 2020

Pharmacy information available at anthem.com

June 2020 Anthem Provider News - Missouri Pharmacy Jun 1, 2020

Medical Policy and Clinical Guideline Updates - June 2020

June 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Jun 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - June 2020

June 2020 Anthem Provider News - Missouri Pharmacy Jun 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

June 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Jun 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)

June 2020 Anthem Provider News - Missouri Reimbursement Policies Jun 1, 2020

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
COVID-19 Information - Missouri Administrative Jun 1, 2020

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News - Missouri Products & Programs Jun 1, 2020

Anthem enhances process for submitting behavioral health authorizations - now available

June 2020 Anthem Provider News - Missouri Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News - Missouri Behavioral Health Jun 1, 2020

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

June 2020 Anthem Provider News - Missouri Administrative Jun 1, 2020

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

June 2020 Anthem Provider News - Missouri Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News - Missouri Administrative Jun 1, 2020

Quality Corner: CPT® Category II Codes - Collaborating for enhanced patient care

June 2020 Anthem Provider News - Missouri Administrative Jun 1, 2020

REMINDER: AIM Rehabilitative Program Pediatric Exclusions

June 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Jun 1, 2020

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Missouri Medicare Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (Updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Missouri Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Missouri Administrative May 29, 2020

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Missouri Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Missouri Administrative May 1, 2020

COVID-19 information repository for Anthem Care Providers

May 2020 Anthem Provider News - Missouri Administrative May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - May 2020

May 2020 Anthem Provider News - Missouri Pharmacy May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines May 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)

May 2020 Anthem Provider News - Missouri Reimbursement Policies May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News - Missouri Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News - Missouri Administrative May 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Missouri Reimbursement Policies May 1, 2020

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News - Missouri Medicare May 1, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Missouri Administrative Apr 10, 2020

Information from Anthem for Care Providers about COVID-19

*Please bookmark/add to favorites Provider News Home for the latest information about COVID-19.
April 2020 Anthem Provider News - Missouri Administrative Apr 1, 2020

Anthem continues focus on updates to our public provider website

April 2020 Anthem Provider News - Missouri Administrative Apr 1, 2020

MCG Care Guidelines 24th Edition*

April 2020 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Apr 1, 2020

REMINDER: Reimbursement Policy - Facility Revenue Code Billing

April 2020 Anthem Provider News - Missouri Reimbursement Policies Apr 1, 2020

Provider Transparency Update

April 2020 Anthem Provider News - Missouri Administrative Apr 1, 2020
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