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Title Publication Category Date

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update*

*Notice of Material Amendment/Change to contract (MAC)

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

New policy for EMR clinical data sharing and ADT notifications*

*Notice of Material Amendment/Change to Contract (MAC)
March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

You are invited: Advancing Mental Health Equity for Youth & Young Adults

Register today for the Advancing Mental Health Equity for Youth & Young Adults forum hosted by Anthem Blue Cross and Blue Shield (Anthem) and Motivo* for Anthem providers on March 15, 2023.
March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Reimbursement policy update: Modifiers 25 and 57 - Professional

March 2023 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2023

Specialty pharmacy updates for March 2023*

*Notice of Material Amendment/Change to contract (MAC)

March 2023 Anthem Provider News - Ohio Pharmacy Mar 1, 2023

Member referrals: Employment Services Program and Housing Flex Funds

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Enhancing Provider News website and email communications

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Member ID cards

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Keep up with Medicare News - March 2023

- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List in Ohio
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

March is National Colorectal Cancer Awareness Month

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Reminder - Updated Carelon Musculoskeletal Program effective April 1, 2023: monitored anesthesia care reviews

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

March 2023 Anthem Provider News - Ohio Products & Programs Mar 1, 2023

Pharmacy information available on our provider website

March 2023 Anthem Provider News - Ohio Pharmacy Mar 1, 2023

Annual planned visits

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Shared savings and transition care management after inpatient discharges

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Informational Update Modifier Usage

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

February 2023 Anthem Provider News - Ohio Administrative Feb 1, 2023

AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.

February 2023 Anthem Provider News - Ohio Administrative Feb 1, 2023

Do you offer telehealth services? Let us know!

February 2023 Anthem Provider News - Ohio Administrative Feb 1, 2023

Have you reviewed your online provider directory information lately?

February 2023 Anthem Provider News - Ohio Administrative Feb 1, 2023

Enhancing Provider News website and email communications

February 2023 Anthem Provider News - Ohio Digital Tools Feb 1, 2023

Medical Policies and Clinical Guidelines updates - February 2023*

*Notice of Material Amendment/Change to contract (MAC)

February 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2023

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update*

*Notice of Material Amendment/Change to contract (MAC)

February 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2023

Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements

February 2023 Anthem Provider News - Ohio Digital Tools Feb 1, 2023

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines*

*Notice of Material Amendment/Change to contract (MAC)

February 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2023

Specialty pharmacy updates - February 2023*

*Notice of Material Amendment/Change to contract (MAC)

February 2023 Anthem Provider News - Ohio Pharmacy Feb 1, 2023

Electronic data interchange overview

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Custom Learning Center located on Availity Essentials Payer Spaces

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Electronic remittance advice (835)

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023

February 2023 Anthem Provider News - Ohio Medicare Feb 1, 2023

Anthem Blue Cross and Blue Shield reimbursement policies

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

2023 FEP benefit information available online

February 2023 Anthem Provider News - Ohio Federal Employee Plan (FEP) Feb 1, 2023

Provider Pathways - eLearning from Anthem Blue Cross and Blue Shield

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

The difference between Medicaid and Commercial

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Access instant health plan information via Availity Essentials

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Introducing the Provider Learning Hub for Anthem Blue Cross and Blue Shield

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Pregnancy notification process using the benefit look-up tool

February 2023 Anthem Provider News - Ohio Medicaid Feb 1, 2023

Keep up with Medicare News - February 2023

- Introducing the Provider Learning Hub for Anthem Blue Cross and Blue Shield
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Fylnetra)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Spevigo, Xenpozyme)
- Specialty pharmacy precertification list expansion (Rolvedon, Stimufend)
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirement changes effective April 1, 2023
- Medical Policies and Clinical Utilization Management Guidelines update
February 2023 Anthem Provider News - Ohio Medicare Feb 1, 2023

Important reminder: New ID cards for many of our Anthem Blue Cross and Blue Shield members

New ID cards for Anthem Blue Cross and Blue Shield members - Ohio Administrative Jan 19, 2023

Telephonic-only care allowance extended through April 11, 2023

Telephonic-only care allowance extended through April 11, 2023 - Ohio Administrative Jan 11, 2023

Notification regarding reimbursement changes to COVID-19 laboratory services codes*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Administrative Dec 30, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines - Material adverse change*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 30, 2022

Specialty pharmacy updates*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Pharmacy Dec 30, 2022

This is Quitting: Helping teens and young adults quit vaping

January 2023 Anthem Provider News - Ohio Medicaid Dec 30, 2022

Anthem Blue Cross and Blue Shield provider orientations

January 2023 Anthem Provider News - Ohio Medicaid Dec 30, 2022

Keep up with Medicare news - January 2023

- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
January 2023 Anthem Provider News - Ohio Medicare Dec 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases*

*Notice of Material Amendment/Change to Contract (MAC)
January 2023 Anthem Provider News - Ohio Federal Employee Plan (FEP) Dec 30, 2022

Cleveland-Cliffs offers Medicare Advantage option

January 2023 Anthem Provider News - Ohio Medicare Dec 30, 2022

Outpatient facility revenue code billing requirements

January 2023 Anthem Provider News - Ohio Reimbursement Policies Dec 30, 2022

Professional system updates for 2023

January 2023 Anthem Provider News - Ohio Administrative Dec 30, 2022

Outpatient system updates for 2023

January 2023 Anthem Provider News - Ohio Administrative Dec 30, 2022

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

January 2023 Anthem Provider News - Ohio Administrative Dec 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

January 2023 Anthem Provider News - Ohio Administrative Dec 30, 2022

Prior authorization suspension for Anthem Ohio in-network hospital transfers to in-network skilled nursing facilities effective December 20, 2022 to January 15, 2023

Prior authorization suspension - In-network hospital transfers to In-network SNFs Administrative Dec 21, 2022

Attention lab providers: COVID-19 update regarding reimbursement*

*Notice of Material Amendment/Change to Contract (MAC)
December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Coordination of care

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Case management program

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Important information about utilization management

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Specialty pharmacy updates - December 2022*

*Notice of Material Amendment/Change to contract (MAC)
December 2022 Anthem Provider News - Ohio Pharmacy Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*

*Notice of Material Amendment/Change to contract (MAC)
December 2022 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2022

Medical Policies and Clinical Guidelines updates - December 2022*

*Notice of Material Amendment/Change to contract (MAC)
December 2022 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Notice of Material Amendment/Change to contract (MAC)

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

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

*Notice of Material Amendment/Change to contract (MAC)

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

Keep up with Medicare News - December 2022

- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
- Signature requirements for laboratory orders or requisitions
December 2022 Anthem Provider News - Ohio Medicare Dec 1, 2022

Wound Care Connect program for Medicare Advantage and Group Retiree members

December 2022 Anthem Provider News - Ohio Medicare Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Anthem Provider News - Ohio Medicare Dec 1, 2022

Member assessment of PCP after-hours messaging in 2022

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Member’s assessment of behavioral healthcare after-hours messaging in 2022

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Members’ rights and responsibilities

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

CAA: Timely updates help keep our provider directories current

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Clinical practice and preventive health guidelines available on anthem.com

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Signature requirements for laboratory orders or requisitions

December 2022 Anthem Provider News - Ohio Administrative Dec 1, 2022

Pharmacy information available on the provider website

December 2022 Anthem Provider News - Ohio Pharmacy Dec 1, 2022

Personal home helper benefit ending

December 2022 Anthem Provider News - Ohio Medicare Dec 1, 2022

PCP searches in Find Care

PCP searches in Find Care - Ohio Administrative Nov 2, 2022

Blue High Performance Network expanded to include Dayton, Ohio region

November 2022 Anthem Provider News - Ohio Administrative Nov 1, 2022

Claims status message enhancements: providing clear descriptions and actionable next steps

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022

Authorization application enhancements: faster, easier, and more efficient

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022

Submit digital attachments within seven-calendar days for claims filed with a PWK segment indicator

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022

You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022

Visit the Provider Learning Hub to view our latest learning opportunities

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022

Specialty pharmacy updates - November 2022

Notice of Material Amendment/Change to Contract (MAC)

November 2022 Anthem Provider News - Ohio Pharmacy Nov 1, 2022

Medical policy and clinical guideline updates - November 2022

Notice of Material Amendment/Change to Contract (MAC)
November 2022 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2022

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

November 2022 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2022

Correction to reimbursement policy: Place of Service - Facility

Notice of Material Amendment/Change to Contract (MAC)

November 2022 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2022

Anthem Blue Cross and Blue Shield provider orientations

November 2022 Anthem Provider News - Ohio Medicaid Nov 1, 2022

Access instant health plan information via Availity Essentials on December 1, 2022

November 2022 Anthem Provider News - Ohio Medicaid Nov 1, 2022

Custom Learning Center located on Availity Essentials Payer Spaces

November 2022 Anthem Provider News - Ohio Medicaid Nov 1, 2022

Keep up with Medicare News - November 2022

- Medical drug benefit Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
- New specialty pharmacy medical step therapy requirements (Zarxio)
November 2022 Anthem Provider News - Ohio Medicare Nov 1, 2022

Personalized Match

November 2022 Anthem Provider News - Ohio Medicare Nov 1, 2022

CAA: Keep your provider directory information up to date

November 2022 Anthem Provider News - Ohio Administrative Nov 1, 2022

Remote EMR access service for HEDIS

November 2022 Anthem Provider News - Ohio Digital Tools Nov 1, 2022
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