Ohio
Provider Communications

Provider Spotlight

Mar 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - March 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.


Articles Recent

Title Publication Category Date

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Ohio Pharmacy Mar 1, 2021

Updates for specialty pharmacy are available - March 2021*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Ohio Pharmacy Mar 1, 2021

Some HIV medication combinations may require prior authorization

March 2021 Anthem Provider News - Ohio Pharmacy Mar 1, 2021

Medical attachment capability now includes itemized bills and more!

March 2021 Anthem Provider News - Ohio Administrative Mar 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Mar 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

March 2021 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Medical policies and clinical utilization management guidelines update

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - March 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
March 2021 Anthem Provider News - Ohio Administrative Mar 1, 2021

Anthem clarifies guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNFs)*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Mar 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - February 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
February 2021 Anthem Provider News - Ohio Administrative Feb 1, 2021

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2021 Anthem Provider News - Ohio Pharmacy Feb 1, 2021

Designated specialty pharmacy network*

February 2021 Anthem Provider News - Ohio Pharmacy Feb 1, 2021

Prior authorization updates for specialty pharmacy are available - February 2021*

February 2021 Anthem Provider News - Ohio Pharmacy Feb 1, 2021

Pharmacy information available at anthem.com

February 2021 Anthem Provider News - Ohio Pharmacy Feb 1, 2021

New provider directory indicator for telehealth services

February 2021 Anthem Provider News - Ohio Administrative Feb 1, 2021

New Anthem utilization management tool now available on Availity: Authorization Rules Lookup tool

February 2021 Anthem Provider News - Ohio Administrative Feb 1, 2021

Medical Policy and Clinical Guideline Updates - February 2021*

February 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2021

Reimbursement policy update: Emergency Room Transfers - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

PN for UM AROW Item 1330

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

Information from Anthem for Care Providers about COVID-19 (updated January 26, 2021)

We recently updated information about COVID-19 vaccines.
COVID-19 Information - Ohio Administrative Jan 26, 2021

Register today for The Road to Allyship Forum hosted by Anthem and Motivo on February 3, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and the importance of allies.
The Road to Allyship Forum Invitation Administrative Jan 21, 2021

Important COVID-19 update: Prior authorization and other policy adjustments (Updated January 13, 2021)

Prior authorization requirements updated for patient transfers from acute inpatient hospitals to skilled nursing facilities.
COVID-19 Information - Ohio Administrative Jan 13, 2021

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated January 8, 2021)

We’ve updated information about coverage for telephonic-only care.
COVID-19 Information - Ohio Administrative Jan 8, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - January 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

IngenioRx introduces new pharmacy network in 2021

January 2021 Anthem Provider News - Ohio Pharmacy Jan 1, 2021

Prior authorization updates for specialty pharmacy are available - January 2021*

January 2021 Anthem Provider News - Ohio Pharmacy Jan 1, 2021

It is almost CAHPS survey time!

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Evaluation and management changes 2021

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

New Blue HPN® plans go live January 1, 2021

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Outpatient system updates for 2021 - Facility

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Professional system updates for 2021

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

New features added to Interactive Care Reviewer

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Procedure searches in Find Care: New sort option

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Availity attachment tools for Anthem and affiliate payers - Live webinars

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Self-service, digital transactions are fast and easy

January 2021 Anthem Provider News - Ohio Administrative Jan 1, 2021

Medical Policy and Clinical Guideline Updates - January 2021*

January 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jan 1, 2021

MCG Care Guidelines 24th Edition Customization*

January 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jan 1, 2021

Anthem implements pilot program for in-network skilled nursing facilities (SNF)

January 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency editing - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2021

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

2020 Medicare risk adjustment provider trainings

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - December 2020

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

New Blue HPN® plans go live Jan. 1, 2021

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Anthem and Quest Diagnostics form strategic relationship

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Updated BlueCard® Provider Manual available

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Anthem contracted air ambulance providers for Ohio

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Joint announcement to end delegation in Ohio

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Pilkington North America, Inc. offers Medicare Advantage option

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Access requirements for behavioral health care services

December 2020 Anthem Provider News - Ohio Behavioral Health Dec 1, 2020

Prior authorization updates for specialty pharmacy are available - December 2020*

December 2020 Anthem Provider News - Ohio Pharmacy Dec 1, 2020

AIM IVR changes for non-oncology medical specialty drug reviews effective Jan. 1, 2021

December 2020 Anthem Provider News - Ohio Pharmacy Dec 1, 2020

Pharmacy information available at anthem.com

December 2020 Anthem Provider News - Ohio Pharmacy Dec 1, 2020

Access to claim denial information is now self-service

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

2-minute videos to engage patients about preventive care

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Anthem makes going digital easy with the Provider Digital Engagement Supplement

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

PCP after-hours access requirements

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Coordination of care

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Members’ rights and responsibilities

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Important information about utilization management

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Case management program

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Medical policy and clinical guideline updates - December 2020*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Anthem expands hospice policy

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Cardiology clinical appropriateness guidelines*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Imaging clinical appropriateness guideline*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Radiation Oncology clinical appropriateness guideline*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Clinical practice and preventive health guidelines available on anthem.com

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

December 2020 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2020

2021 Medicare Advantage individual benefits and formularies

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Medical policies and clinical utilization management guidelines update

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Policy Update: Emergency Department: Leveling of Evaluation and Management Services

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - November 2020

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

IngenioRx Introduces new pharmacy network in 2021

November 2020 Anthem Provider News - Ohio Pharmacy Nov 1, 2020

Prior authorization updates for specialty pharmacy are available - November 2020*

November 2020 Anthem Provider News - Ohio Pharmacy Nov 1, 2020

Availity attachment tools for Anthem and affiliate payers - Live Webinars

Sign up for upcoming webinars!
November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

Clinical Laboratory Improvement Amendments (CLIA) Number - Additional Information

November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

Get the full picture of your patient’s health through their smartphone

November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

US Antibiotic Awareness Week

November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

Medical policy and clinical guideline updates - November 2020*

November 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2020

Correction to Prior Authorization Update for Commercial business*

November 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2020

Reminder: Post-service reviews using AIM

November 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2020

New reimbursement policy: Documentation standards for episodes of care (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Modifier rules (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020
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