Nevada
Provider Communications

August 2020 Anthem Provider News and Important Updates -- Nevada

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Title Category

2020 Medicare risk adjustment provider trainings

Medicare

Anthem Electronic Attachments -- X12 275 5010

Administrative

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

Material Adverse Change (MAC)
Pharmacy

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

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

Material Adverse Change (MAC)
Administrative

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

Administrative

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

Administrative

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

Material Adverse Change (MAC)
Administrative

Keep up with Medicaid news

Medicaid

Keep up with Medicare news

Medicare

Medical drug benefit Clinical Criteria updates

Medicare

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Medical Record Standards

Medical Policy & Clinical Guidelines

Migrate Your EDI Transactions to Availity Today

Administrative

New MCG Care Guidelines 24th edition

Medicare

Non-participating lab referrals

Administrative

Pharmacy information available on anthem.com

Pharmacy

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

Administrative

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

Reimbursement Policies

Resources to support diverse patients and communities

Administrative

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

Pharmacy
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