Nevada
Provider Communications

February 2019 Anthem Provider Newsletter - NV

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Title Category

Anthem eye refraction and routine eye exam billing information

Medicare

Clear Claim Connection: our web-based claim edit tool

Reimbursement Policies

Coding spotlight: diabetes - provider guide to coding the diagnosis and treatment of diabetes

Medicaid

HEDIS 2019 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

Medicaid

Keep up with Medicare news

Medicare

Medical Policies and Clinical Utilization Management Guidelines update

Medicaid

Member Satisfaction with Behavioral Health Outpatient Services

Behavioral Health

My Diverse Patients: a website to support your diverse patients

Medicaid

New specialty Medicare Part B device preferred product program

Medicare

New specialty pharmacy medical step therapy requirements

Medicaid

Pharmacy information available on anthem.com

Pharmacy

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

Medicaid

Prior authorization requirements for Sublocade

Medicaid

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

Administrative

Reimbursement Policies are available online

Reimbursement Policies

Reminder - Anthem follows Original Medicare policies

Medicare

Reminder: Review ICD-10-CM Coding Guidelines (Professional)

Reimbursement Policies

Retroactive rate adjustments

Medicaid

Significant Edits (Professional)

Reimbursement Policies

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred (Professional)

Reimbursement Policies

Updated Escalation Contact List

Administrative

Use grouped CPT codes for AIM Specialty Health authorizations

Medicare
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