New Hampshire
Provider Communications

December 2018 Anthem New Hampshire Provider Newsletter

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Title	Category
Update to AIM Clinical Appropriateness Guidelines	Products & Programs
Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines	Products & Programs
Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines	Products & Programs
Member’s access to behavioral health care	Behavioral Health
Introducing new clinical criteria page for injectable, infused or implanted drugs	Pharmacy
Electronic prior authorization requests for prescription medications accepted online	Pharmacy
Pharmacy information available on anthem.com	Pharmacy
Sign up today for provider eUpdates	Administrative
Payment recovery process simplified for National Accounts membership	Administrative
Availity to serve as EDI entry point for electronic submissions	Administrative
Attention providers certified or licensed in acupuncture: Join Anthem's new acupuncture provider network	Administrative
Ensure the accuracy of your information in the provider directory	Administrative
Misrouted protected health information (PHI)	Administrative
HEDIS® 2018 commercial results are in	Administrative
Clinical practice and preventive health guidelines available on anthem.com	Administrative
Case Management Program	Administrative
ConditionCare Program benefits members and physicians	Administrative
Coordination of care	Administrative
Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits members and physicians	Administrative
Important Information about Utilization Management	Administrative
Members’ Rights and Responsibilities	Administrative
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid available on anthem.com	Administrative
Bundled Services and Supplies: professional	Reimbursement Policies
Reimbursement for convenience surgical supply kits: professional	Reimbursement Policies
Scope of License reimbursement policy update: professional	Reimbursement Policies
“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services: professional	Reimbursement Policies
System updates for 2019: professional	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
Update on clinical guideline communication in October 2018 provider newsletter	Medical Policy & Clinical Guidelines
Benefit change for Infliximab for Federal Employee Program®	Federal Employee Plan (FEP)
Coordination of benefits for a Federal Employee Program® (FEP®) member	Federal Employee Plan (FEP)
2019 FEP® benefit information available online	Federal Employee Plan (FEP)
New Medicare Advantage provider service phone number beginning January 1, 2019	Medicare
2019 Medicare Advantage individual benefits and formularies	Medicare
CMS Medicare Preclusion List effective April 1, 2019	Medicare
When and how to initiate Medicare Advantage reopenings	Medicare
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019	Medicare
Medicare Part B drugs may include Step Therapy beginning January 1, 2019	Medicare
New MediBlue Select HMO Network effective January 1, 2019	Medicare
State of New Hampshire offers Medicare Advantage option	Medicare
Keep up with Medicare news	Medicare
Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional during the Postoperative Period: professional	Reimbursement Policies

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem websites constitutes your agreement with our Terms of Use.