Nevada
Provider Communications

Provider Spotlight

Apr 28, 2021

Information from Anthem for Care Providers about COVID-19 (Updated April 28, 2021)

We recently updated the effective date about reimbursement for the administration of the COVID-19 vaccine.


Articles Recent

Title Publication Category Date

Reminder Guided Access HMO effective January 1, 2020 Clark, Nye/Expanded to Washoe January 1, 2021

May 2021 Anthem Provider News - Nevada Products & Programs May 1, 2021

Modification to voluntary Cancer Care Quality Program (CCQP) Enhanced Reimbursement to begin July 1, 2021

May 2021 Anthem Provider News - Nevada Products & Programs May 1, 2021

Updated AIM Rehabilitative program effective August 1, 2021 – Initial Evaluations and Site of Service reviews (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News - Nevada Products & Programs May 1, 2021

Updates for Specialty pharmacy effective August 1, 2021 (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News - Nevada Pharmacy May 1, 2021

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News - Nevada Pharmacy May 1, 2021

A helpful and complete guide to covered well-child visits

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

May is National High Blood Pressure Education Month

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Non-participating lab referrals

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Provider bulletins for medical and itemized bill attachments

Electronic Solutions @ Your Fingertips
May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Send larger digital attachments through Availity

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Resources to support diverse patients and communities

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Appointment scheduler application

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Referring to network DME providers for Negative Pressure Wound Therapy helps members save on out-of-pocket costs

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

2021 Affirmative Statement Regarding Utilization Management Decisions

May 2021 Anthem Provider News - Nevada Administrative May 1, 2021

Update to AIM Specialty Health Oncologic Imaging Clinical Appropriateness Guidelines

May 2021 Anthem Provider News - Nevada Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy reminder: Readmission (Facility)

May 2021 Anthem Provider News - Nevada Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency Editing (Professional)

May 2021 Anthem Provider News - Nevada Reimbursement Policies May 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation (Facility) (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News - Nevada Reimbursement Policies May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Nevada Medicaid May 1, 2021

Foundations Counseling Center

May 2021 Anthem Provider News - Nevada Medicaid May 1, 2021

Updates to the AIM Advanced Imaging Clinical Appropriateness Guidelines

May 2021 Anthem Provider News - Nevada Medicaid May 1, 2021

Keep up with Medicaid news

May 2021 Anthem Provider News - Nevada Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Nevada Medicare May 1, 2021

Keep up with Medicare news

May 2021 Anthem Provider News - Nevada Medicare May 1, 2021

Information from Anthem for Care Providers about COVID-19 (Updated April 28, 2021)

We recently updated the effective date about reimbursement for the administration of the COVID-19 vaccine.

COVID-19 Information - Nevada Administrative Apr 28, 2021

UPDATE--Site of Care medical necessity reviews for long-acting colony-stimulating factors begin August 1, 2021 (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Products & Programs Apr 1, 2021

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

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2021

Pharmacy information available on anthem.com

April 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2021

Change Notification to Provider and Facility Manual effective July 1, 2021 (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

MCG Care Guidelines 25th Edition (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Apr 1, 2021

Clinic Charges (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021

Newborn Inpatient Stays (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Prior authorization updates for specialty pharmacy -- April

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Iron Infusion Medical Step Therapy Notice

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Prior authorization required for specialty pharmacy -- May

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Keep up with Medicaid news

April 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Interactive bilingual website taking action for our health

April 2021 Anthem Provider News and Important Updates -- Nevada Products & Programs Apr 1, 2021

Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services

April 2021 Anthem Provider News and Important Updates -- Nevada Products & Programs Apr 1, 2021

The heath of millennials: Trends in behavioral health conditions

April 2021 Anthem Provider News and Important Updates -- Nevada Behavioral Health Apr 1, 2021

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

April 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Apr 1, 2021

Maximizing efficient, high quality COVID-19 screenings

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Payer Spaces: name change announcement

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Understanding Availity Roles for Electronic Data Interchange (EDI)

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Make the change to digital authorization/referral and hospital admission notifications using EDI

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Chat directly with a Prior Authorization Specialist

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

UPDATE: For Commercial Providers regarding the AIM Sleep Therapy Program CPT Code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Join Anthem in talking about racism and its impact on health

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

Drug fee schedule update

April 2021 Anthem Provider News and Important Updates -- Nevada Administrative Apr 1, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News and Important Updates -- Nevada Federal Employee Plan (FEP) Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Oncology Dose Reduction Program beginning July 1, 2021

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Clinical Criteria Updates Notification November 2020

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Clinical Criteria Updates Notification December 2020

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Keep up with Medicare news

April 2021 Anthem Provider News and Important Updates -- Nevada Medicare Apr 1, 2021

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021 (MAC)

Material Adverse Change (MAC)
March 2021 Anthem Provider News and Important Updates -- Nevada Products & Programs Mar 1, 2021

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

Material Adverse Change (MAC)
March 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Mar 1, 2021

Some HIV medication combinations may require prior authorization

March 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Mar 1, 2021

Medical attachment capability now includes itemized bill and more!

March 2021 Anthem Provider News and Important Updates -- Nevada Administrative Mar 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery Guideline

March 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Mar 1, 2021

New specialty pharmacy medical step therapy requirements

March 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

March 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards

March 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2021

Keep up with Medicaid news

March 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

March 2021 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2021

Keep up with Medicare news

March 2021 Anthem Provider News and Important Updates -- Nevada Medicare Mar 1, 2021

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

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Feb 1, 2021

Designated specialty pharmacy network (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Feb 1, 2021

Anthem to update formulary list for commercial health plan pharmacy benefit

February 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Feb 1, 2021

Pharmacy information available on anthem.com

February 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Feb 1, 2021

New provider directory indicator for telehealth services

February 2021 Anthem Provider News and Important Updates -- Nevada Administrative Feb 1, 2021

Non-participating lab referrals

February 2021 Anthem Provider News and Important Updates -- Nevada Administrative Feb 1, 2021

Medical Policy and Clinical UM Guideline Updates (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Feb 1, 2021

Emergency Room Transfers (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Feb 1, 2021

Treatment Rooms with Office Evaluation and Management Services (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Feb 1, 2021

CAHPS® survey

February 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Feb 1, 2021

Disease Management/Population Health program

February 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Feb 1, 2021

Radiotherapies and radioimmunotherapies will require prior authorization

February 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Feb 1, 2021

Medical drug benefit Clinical Criteria updates

February 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Feb 1, 2021

Keep up with Medicaid news

February 2021 Anthem Provider News and Important Updates -- Nevada Medicaid Feb 1, 2021

Medical drug benefit Clinical Criteria updates

February 2021 Anthem Provider News and Important Updates -- Nevada Medicare Feb 1, 2021

Keep up with Medicare news

February 2021 Anthem Provider News and Important Updates -- Nevada Medicare Feb 1, 2021

Register today for The Road to Allyship Forum hosted by Anthem and Motivo on February 3, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and the importance of allies.
Register today for The Road to Allyship Forum hosted by Anthem and Motivo on February 3, 2021 - NV Administrative Jan 21, 2021

Important COVID-19 update: Prior authorization and other policy adjustments (Updated January 13, 2021)

We recently updated prior authorization requirements for patient transfers from acute inpatient hospitals to skilled nursing facilities.
COVID-19 Information - Nevada Administrative Jan 13, 2021

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated January 8, 2021)

We’ve updated information about coverage for telephonic-only care.
COVID-19 Information - Nevada Administrative Jan 8, 2021

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

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Jan 1, 2021

IngenioRx Introduces New Pharmacy Network in 2021

January 2021 Anthem Provider News and Important Updates -- Nevada Pharmacy Jan 1, 2021

Availity Attachment Tools for Anthem and Affiliate Payers -- Live Webinars

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

New features added to Interactive Care Reviewer

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

Procedure Searches in Find Care -- New Sort Option

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

Find out in minutes why your claim denied

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

Self-service, digital transactions are fast and easy

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

New Blue HPN® plans in effect

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021

Evaluation and Management Changes 2021

January 2021 Anthem Provider News and Important Updates -- Nevada Administrative Jan 1, 2021
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