Nevada
Provider Communications

December 2020 Anthem Provider News and Important Updates -- Nevada

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Title	Category
Anthem expands hospice benefit	Products & Programs
Case Management Program	Products & Programs
Access requirements for behavioral healthcare services	Behavioral Health
Anthem prior authorization updates for specialty pharmacy are available (MAC) Material Adverse Change (MAC)	Pharmacy
AIM IVR changes for non-oncology medical specialty drug reviews effective on January 1, 2021	Pharmacy
Pharmacy information available on anthem.com	Pharmacy
Anthem makes going digital easy with the Provider Digital Engagement Supplement	Administrative
Access to claim denial information is now self-service	Administrative
New Blue HPN® plans go live on January 1, 2021	Administrative
Anthem contracted Air Ambulance providers in Nevada	Administrative
New utilization management tool now available on Availity Payer Spaces: Authorization Rules Lookup tool	Administrative
Medical Access Standards	Administrative
Coordination of Care	Administrative
Members’ Rights and Responsibilities	Administrative
Important Information about Utilization Management	Administrative
2-minute videos to engage patients about preventive care	Administrative
PCP after-hours access requirements	Administrative
AIM Specialty Health Clinical Appropriateness Guidelines update -- Cardiology (MAC) Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging (MAC) Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Oncology (MAC) Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines	Medical Policy & Clinical Guidelines
Clinical practice and preventive health guidelines available on anthem.com	Medical Policy & Clinical Guidelines
Bundled Services and Supplies (Professional Reimbursement Policy) -- Update	Reimbursement Policies
Digital transactions cut administrative tasks in half	Medicaid
CAHPS education for providers	Medicaid
Anti-VEGF Medical Step Therapy Notice	Medicaid
Avastin Biosimilars Medical Step Therapy Notice	Medicaid
Important reminder – coding requirements for reimbursement for early elective deliveries	Medicaid
Patient360 enhancement for medical providers	Medicaid
Keep up with Medicaid news	Medicaid
Digital transactions cut administrative tasks in half	Medicare
Patient360 enhancement for medical providers	Medicare
Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ	Medicare
2021 Medicare Advantage individual benefits and formularies	Medicare
Transition to AIM Specialty Health Rehabilitative Services Clinical Appropriateness Guidelines	Medicare
Medical Policies and Clinical Utilization Management Guidelines update	Medicare
Keep up with Medicare news	Medicare

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem websites constitutes your agreement with our Terms of Use.