New Hampshire
Provider Communications

December 2018 Anthem New Hampshire Provider Newsletter

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Title Category

2019 FEP® benefit information available online

Federal Employee Plan (FEP)

2019 Medicare Advantage individual benefits and formularies

Medicare

Attention providers certified or licensed in acupuncture: Join Anthem's new acupuncture provider network

Administrative

Availity to serve as EDI entry point for electronic submissions

Administrative

Benefit change for Infliximab for Federal Employee Program®

Federal Employee Plan (FEP)

Bundled Services and Supplies: professional

Reimbursement Policies

Case Management Program

Administrative

Clinical guideline updates are available on anthem.com

Medical Policy & Clinical Guidelines

Clinical practice and preventive health guidelines available on anthem.com

Administrative

CMS Medicare Preclusion List effective April 1, 2019

Medicare

ConditionCare Program benefits members and physicians

Administrative

Coordination of benefits for a Federal Employee Program® (FEP®) member

Federal Employee Plan (FEP)

Coordination of care

Administrative

Electronic prior authorization requests for prescription medications accepted online

Pharmacy

Ensure the accuracy of your information in the provider directory

Administrative

HEDIS® 2018 commercial results are in

Administrative

Important Information about Utilization Management

Administrative

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

Medicare

Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits members and physicians

Administrative

Introducing new clinical criteria page for injectable, infused or implanted drugs

Pharmacy

Keep up with Medicare news

Medicare

Medical policy updates are available on anthem.com

Medical Policy & Clinical Guidelines

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

Medicare

Members’ Rights and Responsibilities

Administrative

Member’s access to behavioral health care

Behavioral Health

Misrouted protected health information (PHI)

Administrative

Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional during the Postoperative Period: professional

Reimbursement Policies

New MediBlue Select HMO Network effective January 1, 2019

Medicare

New Medicare Advantage provider service phone number beginning January 1, 2019

Medicare

Payment recovery process simplified for National Accounts membership

Administrative

Pharmacy information available on anthem.com

Pharmacy

Reimbursement for convenience surgical supply kits: professional

Reimbursement Policies

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

Products & Programs

Scope of License reimbursement policy update: professional

Reimbursement Policies

Sign up today for provider eUpdates

Administrative

State of New Hampshire offers Medicare Advantage option

Medicare

System updates for 2019: professional

Reimbursement Policies

Update on clinical guideline communication in October 2018 provider newsletter

Medical Policy & Clinical Guidelines

Update to AIM Clinical Appropriateness Guidelines

Products & Programs

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

Products & Programs

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid available on anthem.com

Administrative

When and how to initiate Medicare Advantage reopenings

Medicare

“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services: professional

Reimbursement Policies
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