November 1, 2019
November 2019 Anthem Provider News and Important Updates - Nevada
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Administrative
CommercialOctober 31, 2019
Anthem appropriate coding helps provide a comprehensive picture of patients’ healthCommercialOctober 31, 2019
Provider Action Needed: verify your information is correct, and update us with any changes utilizing our online Provider Maintenance FormCommercialOctober 31, 2019
Fall Provider Seminars happening this month -- Registration Deadline November 7, 2019Policy Updates
CommercialOctober 31, 2019
Updates to AIM Sleep Disorder Management Clinical Appropriateness GuidelineCommercialOctober 31, 2019
AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program Spine Surgery (MAC)Material Adverse Change (MAC)
CommercialOctober 31, 2019
AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Therapy (MAC)Material Adverse Change (MAC)
CommercialOctober 31, 2019
AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging of the Abdomen and Pelvis (MAC)Material Adverse Change (MAC)
CommercialOctober 31, 2019
Additional improvements coming to anthem.com regarding Medical Policies and Clinical GuidelinesProducts & Programs
CommercialOctober 31, 2019
Clinical Criteria and prior authorization updates for specialty pharmacy are available (MAC)Material Adverse Change (MAC)
CommercialOctober 31, 2019
Remaining members will transition to new PBM, IngenioRx, on January 1, 2020State & Federal
Medicare AdvantageOctober 31, 2019
Electronic submission is preferred method for requesting pharmacy prior authorizationMedicaidOctober 31, 2019
Keep up with Medicaid newsMedicaidOctober 31, 2019
Prior authorization requirements changes effective November 1, 2019MedicaidOctober 31, 2019
Behavioral health therapy session limitationsMedicaidOctober 31, 2019
March 2019 Medical Policies and Clinical Utilization Management Guidelines updateMedicaidOctober 31, 2019
InterQual 2019 updateMedicaidOctober 31, 2019
Medical drug Clinical Criteria updates Effective date September 5, 2019MedicaidOctober 31, 2019
Medical drug Clinical Criteria updates Effective date August 12, 2019MedicaidOctober 31, 2019
New clinical guideline: pneumatic compression devices, effective December 1, 2019MedicaidOctober 31, 2019
Electronic submission is preferred method for requesting pharmacy prior authorizationMedicaidOctober 31, 2019
June 2019 Medical Policies and Clinical Utilization Management Guidelines updateMedicare AdvantageOctober 31, 2019
Keep up with Medicare newsMedicare AdvantageOctober 31, 2019
Prior authorization requirements changes effective November 1, 2019Medicare AdvantageOctober 31, 2019
CMS reminder: expedited/urgent requestsMedicare AdvantageOctober 31, 2019
Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement (APM ID 0037943)To view this publication online:
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