Anthem adopts MCG care guidelines for physical health - acute care services and behavioral health services

Effective with dates of service on and after October 31, 2018, Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) will begin using the MCG care guidelines 22nd edition for physical health - acute care and behavioral health reviews. This represents a change from the clinical guidelines currently used. Post-acute care reviews will continue to utilize McKesson‑InterQual clinical guidelines.

 

Providers should continue to call the phone number indicated on the back of the member ID card to request prior authorization review or for additional questions regarding physical and behavioral health benefits. If providers have access to Availity, they may initiate a request online at https://www.availity.com.

 

For more information, please contact the Provider Services at 1-844-396-2330.

 

ANV-NU-0001-18 October 2018