Nevada
Provider Communications

Provider Spotlight

Oct 9, 2020

Information from Anthem for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.

Oct 1, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

Oct 1, 2020

New Medical Claim Attachment Webinars: Register Today


Articles Recent

Title Publication Category Date

Register today for a Racial Trauma Forum hosted by Anthem and Motivo on October 28, 2020

Racial Trauma Forum invitation - Nevada Behavioral Health Oct 14, 2020

Information from Anthem for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.
COVID-19 Information - Nevada Administrative Oct 9, 2020

Drug fee schedule update

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

Commercial Risk Adjustment (CRA) Reporting Update: New guidance on telephone-only service CPT codes

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

National Accounts 2021 Pre-certification list

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

REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020

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

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines delayed

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

Laboratory and Venipuncture Services (Professional Reimbursement Policy) -- Update (MAC)

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

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

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

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List (MAC)

Material Adverse Change (MAC)
October 2020 Anthem Provider News and Important Updates -- Nevada Federal Employee Plan (FEP) Oct 1, 2020

Coding spotlight: providers guide to coding for behavioral health disorders

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

What Matters Most online training course: improving patient experience

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

Social determinants of health support expanding with GroundGame Health

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

Keep up with Medicaid news

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

Prior authorization requirements for the below codes

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

Medical drug benefit Clinical Criteria updates (June 2020)

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

Provider transparency update

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

Prior authorization requirements for the below codes

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

Social determinants of health support expanding with GroundGame Health

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

Keep up with Medicare news

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

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

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

Updated Coverage for Breast Cancer prevention medications

October 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Oct 1, 2020

FDA approvals and expedited pathways used -- New Molecular Entities (NMEs)

October 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Oct 1, 2020

Pharmacy information available on anthem.com

October 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Oct 1, 2020

Anthem updates formulary lists for commercial health plan pharmacy benefit

October 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Oct 1, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

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

New Medical Claim Attachment Webinars: Register Today

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

What Matters Most: Improving the Patient Experience

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

Electronic member ID cards available on the Availity Portal

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

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated September 29, 2020)

We are extending cost share waivers for telehealth and telephonic-only care.
COVID-19 Information - Nevada Administrative Sep 29, 2020

Site of Care* medical necessity reviews expand to numerous surgical procedures begin December 1, 2020 (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Nevada Products & Programs Sep 1, 2020

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

September 2020 Anthem Provider News and Important Updates -- Nevada Products & Programs Sep 1, 2020

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

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

Anthem to update formulary lists for commercial health plan pharmacy benefit

September 2020 Anthem Provider News and Important Updates -- Nevada Pharmacy Sep 1, 2020

Anthem Chat: A fast, easy way to have your questions answered

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

EDI Gateway Migration Deadline is September 15, 2020

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

Enhanced Medical Records Submission Process to Support Claims Processing

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

Patient360 Adds Care Gap Alert Feedback for Medical Providers

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

Receive and respond to medical record requests for postpay audit via Change Healthcare’s Attach Assist functionality

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

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

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

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

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

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)

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

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

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

Controlling High Blood Pressure (CBP)

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

Medical drug benefit Clinical Criteria updates (March 2020)

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

Keep up with Medicaid news

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

Medical drug benefit Clinical Criteria updates (March 2020)

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

Medical drug benefit Clinical Criteria updates (May 2020)

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

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
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