New Hampshire
Provider Communications

June 2022 Anthem New Hampshire Provider News

Title	Category
Updates to edits associated with implants	Reimbursement Policies
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (facility)	Reimbursement Policies
Updated AIM Musculoskeletal Program effective September 1, 2022 - site of care reviews	Products & Programs
Updated AIM Musculoskeletal Program effective October 1, 2022	Products & Programs
Specialty pharmacy updates - June 2022	Pharmacy
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	Medicare
Medical policies and clinical utilization management guidelines update	Medicare
Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members	Medicare
Medical drug benefit clinical criteria updates	Medicare
Evaluation and management services for COVID testing - professional	Medicare
Keep up with Medicare news Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines New specialty pharmacy medical step therapy requirements Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines	Medicare
Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines Notice of material change/amendment to contract	Medical Policy & Clinical Guidelines
Process change for Federal Employee Program® third-party correspondence requests	Federal Employee Plan (FEP)
Opioid overdose deaths: What can we do?	Behavioral Health
Update use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services	Administrative
Provider outreach to validate your provider data	Administrative
Once-a-year testing is critically important to providing quality diabetes care	Administrative
CAA: Provider directories accuracy is important	Administrative
Exploring the Intersection of Race and Disability forum	Administrative

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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.

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New Hampshire
Provider Communications

June 2022 Anthem New Hampshire Provider News

Updates to edits associated with implants

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (facility)

Updated AIM Musculoskeletal Program effective September 1, 2022 - site of care reviews

Updated AIM Musculoskeletal Program effective October 1, 2022

Specialty pharmacy updates - June 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medical policies and clinical utilization management guidelines update

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

Medical drug benefit clinical criteria updates

Evaluation and management services for COVID testing - professional

Keep up with Medicare news

Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines

Process change for Federal Employee Program® third-party correspondence requests

Opioid overdose deaths: What can we do?

Update use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services

Provider outreach to validate your provider data

Once-a-year testing is critically important to providing quality diabetes care

CAA: Provider directories accuracy is important

Exploring the Intersection of Race and Disability forum

New HampshireProvider Communications

June 2022 Anthem New Hampshire Provider News

New Hampshire
Provider Communications