Nevada
Provider Communications

December 2021 Anthem Provider News - Nevada

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Title	Category
Important information about utilization management	Administrative
Member rights and responsibilities	Administrative
Coordination of care	Administrative
Professional system updates for 2022	Administrative
Clinical practice and preventive health guidelines available on anthem.com	Administrative
Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date	Administrative
Outpatient system updates for 2022	Administrative
Chlamydia is asymptomatic. Only through screening will we know for sure.	Administrative
Behavioral healthcare appointment access requirements	Administrative
Importance of PCP after-hours messaging	Administrative
Non-participating lab referrals	Administrative
UPDATE: Implementation of provider claim payment dispute process for Commercial lines of business has been delayed	Administrative
Reminder: EnrollSafe is available: electronic funds transfer enrollment portal for Anthem Blue Cross and Blue Shield providers EnrollSafe replaced CAQH Enrollhub effective November 1, 2021	Digital Tools
Submitting prior authorizations is getting easier Anthem is transitioning to the Availity Authorization app	Digital Tools
Is prior authorization required? Answering your questions about the new Availity Authorization App	Digital Tools
Company to retire Blue Precision program on December 31, 2021	Products & Programs
Case Management Program	Products & Programs
December 2021 specialty pharmacy updates (MAC) Material adverse change (MAC)	Pharmacy
Pharmacy information available on anthem.com	Pharmacy
Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline (MAC) Material adverse change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (MAC) Material adverse change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline (MAC) Material adverse change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Advanced Imaging Clinical Appropriateness Guideline (MAC) Material adverse change (MAC)	Medical Policy & Clinical Guidelines
Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) (Professional) (MAC) Material adverse change (MAC)	Reimbursement Policies
Reimbursement policy update: Virtual Visits (professional and facility)	Reimbursement Policies
RETRACTION: Inpatient Facility Transfers reimbursement policy (facility)	Reimbursement Policies
New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams (professional)	Reimbursement Policies
Policy Update: Drug Screen Testing Medicare Advantage	Medicare
2022 Medicare Advantage service area and benefit updates Medicare Advantage	Medicare
Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies Medicare Advantage	Medicare
Somatus is your resource for kidney care management Medicare Advantage	Medicare
Submitting prior authorizations is getting easier Medicare Advantage	Medicare
Claims editing update for ICD-10-CM Excludes1 notes Medicaid	Medicaid
Keep up with Medicare news Medicare Advantage Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline Medical drug benefit Clinical Criteria updates Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions New York City Medicare Advantage announcement Medical Policies and Clinical Utilization Management Guidelines update	Medicare
Non-payment remittance advice enhancements Medicaid	Medicaid
Submitting prior authorizations is getting easier Medicaid	Medicaid
Policy Update: Drug Screen Testing Medicaid	Medicaid
Prior authorization updates for medications billed under the medical benefit Medicaid	Medicaid
Keep up with Medicaid news Medicaid Medical Policies and Clinical Utilization Management Guidelines update Getting tobacco users the help they need to quit Adult outpatient urology and ophthalmology surgery precertification initiative Durable medical equipment prior authorization requirement changes effective December 1, 2021 Medical drug benefit Clinical Criteria updates Provider administered drugs The state of Nevada to reassign members to new health plans in 2022	Medicaid

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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.