Nevada
Provider Communications

Provider Spotlight

Aug 10, 2020

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.


Articles Recent

Title Publication Category Date

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.
COVID-19 Information - Nevada Administrative Aug 10, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Aug 1, 2020

Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020

August 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Aug 1, 2020

Change Notification to Provider and Facility Manual effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Expansion of AIM Musculoskeletal Program Effective November 1, 2020 (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Commercial Risk Adjustment (CRA): Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Non-participating lab referrals

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Migrate Your EDI Transactions to Availity Today

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Anthem Electronic Attachments -- X12 275 5010

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Prior Authorization/Referral Request and Inpatient Admission/Discharge Notification transactions coming soon

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Clinical Laboratory Improvement Amendments (CLIA) ID number required for electronic claims submissions

August 2020 Anthem Provider News and Important Updates -- Nevada Administrative Aug 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Aug 1, 2020

Medical Record Standards

August 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement policy update -- Claims Requiring Additional Documentation (Facility)

August 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Aug 1, 2020

Keep up with Medicaid news

August 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Aug 1, 2020

Medical drug benefit Clinical Criteria updates

August 2020 Anthem Provider News and Important Updates -- Nevada Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News and Important Updates -- Nevada Medicare Aug 1, 2020

New MCG Care Guidelines 24th edition

August 2020 Anthem Provider News and Important Updates -- Nevada Medicare Aug 1, 2020

Keep up with Medicare news

August 2020 Anthem Provider News and Important Updates -- Nevada Medicare Aug 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 and Important Updates -- Nevada Products & Programs Jul 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Jul 1, 2020

Updated Coverage for HIV PrEP medications

July 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Jul 1, 2020

Drug fee schedule update

July 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jul 1, 2020

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations (MAC)

Material Adverse Change (MAC)
July 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News and Important Updates -- Nevada 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 and Important Updates -- Nevada Federal Employee Plan (FEP) Jul 1, 2020

Medical drug benefit Clinical Criteria updates

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Complex Case Management program

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Important information about utilization management

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Members’ Rights and Responsibilities Statement

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to code social determinants of health

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to coding for cardiovascular conditions

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

Keep up with Medicaid news

July 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jul 1, 2020

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

July 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jul 1, 2020

Medical drug benefit Clinical Criteria updates

July 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jul 1, 2020

Keep up with Medicare news

July 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jul 1, 2020

Webinar recording now available for network 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 - Nevada 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 telephone-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 - Nevada Administrative Jun 9, 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.
June 2020 Anthem Provider News and Important Updates -- Nevada 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 and Important Updates -- Nevada Products & Programs Jun 1, 2020

Anthem enhances process for submitting Behavioral Health Authorizations

June 2020 Anthem Provider News and Important Updates -- Nevada Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News and Important Updates -- Nevada Behavioral Health Jun 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Jun 1, 2020

Pharmacy information available on anthem.com

June 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy 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 and Important Updates -- Nevada Administrative Jun 1, 2020

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

June 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jun 1, 2020

Updated Escalation Contact List -- Nevada

June 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jun 1, 2020

Quality Corner: CPT® Category II codes – Collaborating for enhanced patient care

June 2020 Anthem Provider News and Important Updates -- Nevada Administrative Jun 1, 2020

Transition to AIM Clinical Appropriateness Guidelines -- Rehabilitative Services (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jun 1, 2020

Nurse Practitioner and Physician Assistant Service (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News and Important Updates -- Nevada 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 and Important Updates -- Nevada Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Resources supporting our providers during COVID-19

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Keep up with Medicare news

June 2020 Anthem Provider News and Important Updates -- Nevada Medicare Jun 1, 2020

Notification for ambulatory medical record review

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid Jun 1, 2020

Keep up with Medicaid news

June 2020 Anthem Provider News and Important Updates -- Nevada Medicaid 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 - Nevada 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 - Nevada 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 - Nevada 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 - Nevada Administrative May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Reminder about System Updates

May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

Keep up with Medicare news

May 2020 Anthem Provider News and Important Updates -- Nevada Medicare May 1, 2020

COVID-19 information repository for Anthem care Providers

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Non-participating lab referrals

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

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

May 2020 Anthem Provider News and Important Updates -- Nevada Administrative May 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Pre-Service/Prior Authorization Clinical Review Update -- May 2020 (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Sleep Disorder Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- MSK Interventional Pain Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Claims requiring additional documentation (Facility Reimbursement Policy -- Update for Inpatient and Outpatient) (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Reimbursement Policy: Policy Update-Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Disease Management can help you care for patients with chronic health care needs

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Medical drug benefit Clinical Criteria updates December 2019

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Postpartum incentives

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

CPT II obstetrical billing information

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid May 1, 2020

Keep up with Medicaid news

May 2020 Anthem Provider News and Important Updates -- Nevada Medicaid 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 - Nevada Administrative Apr 10, 2020

Anthem prior authorization updates for specialty pharmacy are available (MAC)

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Anthem to delay most April 1, 2020 formulary list updates for commercial health plan pharmacy benefit

April 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2020

Information from Anthem for Care Providers about COVID-19

Bookmark Provider News Home for the latest information for Care Providers about COVID-19.
April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

REMINDER: New AIM Rehabilitative Program effective April 1, 2019

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020

Laboratory Medicine Consultants is no longer a Participating Provider effective April 1, 2020

April 2020 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2020
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