Nevada
Provider Communications

July 2020 Anthem Provider News and Important Updates -- Nevada

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Title Category

UPDATE: New Go Live Date for Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures

Products & Programs

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

Material Adverse Change (MAC)
Pharmacy

Updated Coverage for HIV PrEP medications

Pharmacy

Drug fee schedule update

Administrative

Welcome to the Custom Learning Center in Availity

Administrative

Commercial Risk Adjustment (CRA) 2020 Program Year Progression: What’s in it for you and your patients?

Administrative

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

New MCG 24th Edition Guidelines

Medical Policy & Clinical Guidelines

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

Federal Employee Plan (FEP)

Medical drug benefit Clinical Criteria updates

Medicaid

Complex Case Management program

Medicaid

Important information about utilization management

Medicaid

Members’ Rights and Responsibilities Statement

Medicaid

Coding spotlight: Provider’s guide to code social determinants of health

Medicaid

Coding spotlight: Provider’s guide to coding for cardiovascular conditions

Medicaid

Keep up with Medicaid news

Medicaid

2020 Special Needs Plans

Medicare

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

Medicare

Medical drug benefit Clinical Criteria updates

Medicare

Keep up with Medicare news

Medicare
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