September 1, 2020

September 2020 Anthem Provider News and Important Updates -- Nevada

Administrative

AdministrativeCommercialAugust 31, 2020

Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program Continues

AdministrativeCommercialAugust 31, 2020

New provider directory indicators for medication assisted treatment (MAT) providers

AdministrativeCommercialAugust 31, 2020

Receive and respond to medical record requests for postpay audit via Change Healthcare’s Attach Assist functionality

AdministrativeCommercialAugust 31, 2020

Patient360 Adds Care Gap Alert Feedback for Medical Providers

AdministrativeCommercialAugust 31, 2020

Enhanced Medical Records Submission Process to Support Claims Processing

AdministrativeCommercialAugust 31, 2020

EDI Gateway Migration Deadline is September 15, 2020

AdministrativeCommercialAugust 31, 2020

Anthem Chat: A fast, easy way to have your questions answered

Policy Updates

Reimbursement PoliciesCommercialAugust 31, 2020

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Reimbursement PoliciesCommercialAugust 31, 2020

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)
Material Adverse Change (MAC)

Products & Programs

Products & ProgramsCommercialAugust 31, 2020

Site of Care* medical necessity reviews expand to numerous surgical procedures begin December 1, 2020 (MAC)
Material Adverse Change (MAC)

Products & ProgramsCommercialAugust 31, 2020

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

PharmacyCommercialAugust 31, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

PharmacyCommercialAugust 31, 2020

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

State & Federal

State & FederalMedicare AdvantageAugust 31, 2020

Medical drug benefit Clinical Criteria updates (May 2020)

State & FederalMedicare AdvantageAugust 31, 2020

Medical drug benefit Clinical Criteria updates (March 2020)

State & FederalMedicaidAugust 31, 2020

Keep up with Medicaid news

State & FederalMedicaidAugust 31, 2020

Medical drug benefit Clinical Criteria updates (March 2020)

State & FederalMedicaidAugust 31, 2020

Controlling High Blood Pressure (CBP)