Nevada
Provider Communications

October 2020 Anthem Provider News and Important Updates -- Nevada

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Title Category

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

Material Adverse Change (MAC)
Pharmacy

Updated Coverage for Breast Cancer prevention medications

Pharmacy

FDA approvals and expedited pathways used -- New Molecular Entities (NMEs)

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Anthem updates formulary lists for commercial health plan pharmacy benefit

Pharmacy

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

Administrative

New Medical Claim Attachment Webinars: Register Today

Administrative

What Matters Most: Improving the Patient Experience

Administrative

Electronic member ID cards available on the Availity Portal

Administrative

Drug fee schedule update

Administrative

Commercial Risk Adjustment (CRA) Reporting Update: New guidance on telephone-only service CPT codes

Administrative

National Accounts 2021 Pre-certification list

Administrative

REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020

Medical Policy & Clinical Guidelines

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines delayed

Medical Policy & Clinical Guidelines

Laboratory and Venipuncture Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
Reimbursement Policies

Reimbursement policy update -- Claims Requiring Additional Documentation policy (Facility)

Reimbursement Policies

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List (MAC)

Material Adverse Change (MAC)
Federal Employee Plan (FEP)

Coding spotlight: providers guide to coding for behavioral health disorders

Medicaid

What Matters Most online training course: improving patient experience

Medicaid

Social determinants of health support expanding with GroundGame Health

Medicaid

Keep up with Medicaid news

Medicaid

Prior authorization requirements for the below codes

Medicare

Medical drug benefit Clinical Criteria updates (June 2020)

Medicare

Provider transparency update

Medicare

Prior authorization requirements for the below codes

Medicare

Social determinants of health support expanding with GroundGame Health

Medicare

Keep up with Medicare news

Medicare
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