New provider manual available
As of today, the new provider manual is available online. Go to anthem.com, and select For Providers. Under the Provider Resources heading, select Policies, Guidelines & Manuals. Select Nevada.
- To access the manual effective November 1, 2022: Under the Provider Manualheading, select Download the Manual under the banner. This version is effective beginning November 1, 2022, but available for review as of August 1, 2022.
- To access the manual still effective until October 31, 2022: Select the link titled Access previous versions and other manuals. See the appropriate historical version using the effective dates listed with each manual.
Changes were made to the following sections:
- Insurance requirements
- Claims submission
- Medical records submission (solicited and unsolicited)
- Electronic Data Interchange (EDI)
- Claim payment disputes
- Clinical appeals
- Reimbursement requirements and policies
- Medical Policies and Clinical Utilization Management (UM) Guidelines
- Utilization Management
- AIM Specialty Health®*
- Quality Improvement Program
- Member rights and responsibilities
- Overview of HEDIS®
- Centers of Medical Excellence
- Audit and review
- Fraud, waste and abuse detection
August 2022 Anthem Provider News - Nevada