Nevada
Provider Communications

July 2022 Anthem Provider News - Nevada

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Title Category

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Administrative

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

Administrative

Clearing up coding confusion for diabetic retinal screenings

Administrative

Update to facility editing: HCPCS code G0463

Administrative

CAA: Keep your provider directory information current

Administrative

Drug fee schedule update

Administrative

Non-participating lab referrals

Administrative

Experience the difference: Your Provider Experience team

Administrative

Coming soon: The Anthem Blue Cross and Blue Shield Provider Learning Hub makes Availity learning easier

Digital Tools

Enhancing claims attachment processes through digital applications

Add attachments through Claims Status Inquiry
Digital Tools

Pharmacy information available online

Pharmacy

Change notification to Medical Policies and Clinical UM Guidelines (MAC)

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Enhanced reimbursement for voluntary Cancer Care Quality program to be discontinued effective December 31, 2022

Medical Policy & Clinical Guidelines

Help patients heal from the comfort of home with Hospital in Home care

Medical Policy & Clinical Guidelines

Reimbursement policy update: Place of Service (Facility)(MAC)

Material adverse change (MAC)
Reimbursement Policies

New reimbursement policy: Transitional Care Management (Professional)

Reimbursement Policies

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU (Professional)(MAC)

Material adverse change (MAC)
Reimbursement Policies

Retraction for reimbursement policy: Sexually Transmitted Infections (Professional)

Reimbursement Policies

New reimbursement policy: Modifier FB (Professional & Facility)(MAC)

Material adverse change (MAC)
Reimbursement Policies

Reimbursement policy update: Laboratory and Venipuncture Services (Professional & Facility)(MAC)

Material adverse change (MAC)
Reimbursement Policies

Reimbursement policy update: Modifier Rules (Professional)(MAC)

Material adverse change (MAC)
Reimbursement Policies

Cancer Care Navigator

Medicare Advantage
Medicare

Help patients heal from the comfort of home with Hospital in Home care

Medicare Advantage
Medicare

Non-participating lab referrals

Medicare Advantage
Medicare

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

Medicare Advantage
Medicare

Keep up with Medicare news

Medicare Advantage

New specialty pharmacy medical step therapy requirements
Medicare

Medical drug benefit Clinical Criteria updates

Medicaid
Medicaid

Medical Policies and Clinical Utilization Management Guidelines update

Medicaid
Medicaid

Drug screening and testing policy changes

Medicaid
Medicaid

Experience the difference: Your Provider Experience team

Medicaid
Medicaid

New process for making requests to the state to consider covering non-covered codes

Medicaid
Medicaid

Keep up with Medicaid news

Medicaid

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Prior authorization updates for medications billed under the medical benefit

Updates for medication codes billed under the medical benefit
Medicaid
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