New Hampshire
Provider Communications

August 2018 Anthem New Hampshire Provider Newsletter

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Title Category

AIM Radiation Oncology Clinical Appropriateness Guidelines updates

Products & Programs

AIM Advanced Imaging Clinical Appropriateness Guidelines updates

Products & Programs

AIM Level of Care Musculoskeletal Surgery Clinical Appropriateness Guidelines updates

Products & Programs

New pre-service clinical review requirement for EGD services begins November 1, 2018

Products & Programs

Additional support available for members with rare conditions

Products & Programs

Anthem engages with Alliant Health Solutions

Behavioral Health

Pharmacy information available on anthem.com

Pharmacy

Drug lists supporting commercial health plans updated

Pharmacy

Daily morphine equivalent dosing limit to apply effective September 1, 2018

Pharmacy

Pre-service clinical review drug list changes effective November 1, 2018

Pharmacy

Level of care pre-service clinical review drug list changes effective November 1, 2018

Pharmacy

Sign-up today for Network eUPDATE - it’s free!

Administrative

Automated claim edits for professional claims to be enhanced

Administrative

Colonoscopy and related anesthesia services billing

Administrative

Vaginal birth after cesarean (VBAC) certified shared decision making aid available on anthem.com

Administrative

Gestational age required for professional delivery claims effective November 1, 2018

Administrative

Care and Cost Finder - new sort option

Administrative

Prior authorization requests for prescription medications accepted online

Administrative

Attention providers certified or licensed in acupuncture

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Availity EDI Gateway

Administrative

Availity EDI Gateway services training webinars scheduled

Administrative

MyDiversePatients.com

Administrative

Member Explanation of Benefits gets a makeover

Administrative

Provider Transparency Update

Administrative

Bundled Services and Supplies - professional

Reimbursement Policies

Once per Lifetime Procedures - professional

Reimbursement Policies

Claims Requiring Additional Documentation (facility) reimbursement policy update

Reimbursement Policies

Medical policy updates are available on anthem.com

Medical Policy & Clinical Guidelines

Clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

Mailing address for Federal Employee Program® (FEP) paper claims and claims-related correspondence

Federal Employee Plan (FEP)

MA members receive incentives for completing screenings

Medicare

Wheelchair prior authorization information for DME providers and physicians

Medicare

Submit PA medication requests electronically; new phone number for MA prescription PAs effective September 1, 2018

Medicare

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

Medicare

Keep up with Medicare news

Medicare
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