Ohio
Provider Communications

Provider Spotlight

Jan 1, 2020

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

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

Jan 1, 2020

Postponed: Review of professional claims with emergency room level 5 E/M codes


Articles Recent

Title Publication Category Date

Medicare News -- January 2020

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Postponed -- Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

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

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

Ohio IAM Local 2848 Retiree VEBA moves to Medicare Advantage plan under Anthem

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Postponed: Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Availity: Upcoming retirement planned for legacy Medical Attachment submission tool

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Let Us Help You Accomplish Your 2020 “To-Do List” Early - EDI Migration

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

The New Year brings New ID Cards for many Anthem members

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

Receive and respond to post pay audit medical record requests via Availity beginning February 10, 2020

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

New Musculoskeletal and Pain Management Solution Effective for Select National ASO Accounts January 1, 2020

January 2020 Anthem Provider News - Ohio Products & Programs Jan 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair*

January 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jan 1, 2020

Outpatient Facility Edit Implementation*

January 2020 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2020

2020 FEP® Benefit information available online

January 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Introducing ConcertoHealth

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Medicare preferred continuous glucose monitors

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

August 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

September 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Electric Boat offers Medicare Advantage options

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

2020 Medicare risk adjustment provider trainings

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Group Retiree Solutions Kentucky and Ohio HMO Medicare Advantage plans

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

State Auto Insurance Companies to offer Medicare Advantage option

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Verifying and updating your provider information

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Anthem works to simplify payment recovery process for National Accounts membership

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Retrieve your Anthem Patient’s HEDIS® care gaps through Patient360 located on the Availity portal

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Case management program

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Coordination of care

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Important information about utilization management

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Members’ rights and responsibilities

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Clinical practice and preventive health guidelines available

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Provider News - Ohio Products & Programs Dec 1, 2019

Coding tip for psychological and neuropsychological testing

December 2019 Anthem Provider News - Ohio Behavioral Health Dec 1, 2019

Pharmacy information available at anthem.com

December 2019 Anthem Provider News - Ohio Pharmacy Dec 1, 2019

New Reimbursement Policies: Durable Medical Equipment, Rent to Purchase Durable Medical Equipment, and Modifiers (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

System updates for 2020 (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

Coordination of benefits for an FEP® member

December 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Dec 1, 2019

Medicare News -- December 2019

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Provider training series

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Reminder to Medicare Advantage providers

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- November 2019

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 2019 Anthem Provider News - Ohio Administrative Nov 1, 2019

Additional improvements coming to anthem.com

November 2019 Anthem Provider News - Ohio Administrative Nov 1, 2019

Appropriate coding helps provide a comprehensive picture of patients’ health

November 2019 Anthem Provider News - Ohio Administrative Nov 1, 2019

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Provider News - Ohio Products & Programs Nov 1, 2019

Anthem clinical criteria and prior authorization updates for specialty pharmacy are available*

November 2019 Anthem Provider News - Ohio Pharmacy Nov 1, 2019

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

November 2019 Anthem Provider News - Ohio Pharmacy Nov 1, 2019

Medical Policy and Clinical Guidelines Updates -- November 2019*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Medicare News -- November 2019

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

Enhanced search and download options allow easy access to information at your fingertips

Oct. 9, 2019 Anthem Provider News - Ohio Administrative Oct 9, 2019

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- October 2019

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.
October 2019 Anthem Provider News - Ohio Administrative Oct 1, 2019

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

October 2019 Anthem Provider News - Ohio Products & Programs Oct 1, 2019

National Accounts 2020 Pre-certification list*

October 2019 Anthem Provider News - Ohio Administrative Oct 1, 2019

Anthem engages Matrix to conduct mobile health clinics and in-home assessments for targeted members

October 2019 Anthem Provider News - Ohio Administrative Oct 1, 2019

Anthem launches additional changes to anthem.com

October 2019 Anthem Provider News - Ohio Administrative Oct 1, 2019

Important update to Anthem’s commercial drug lists

October 2019 Anthem Provider News - Ohio Pharmacy Oct 1, 2019

Anthem specialty pharmacy medical step therapy drug list- clarification

October 2019 Anthem Provider News - Ohio Pharmacy Oct 1, 2019

Pharmacy information available at anthem.com

October 2019 Anthem Provider News - Ohio Pharmacy Oct 1, 2019

Reimbursement Policy update: Place of Service-Professional*

October 2019 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2019

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review*

October 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2019

Pre-certification information for the Federal Employee Program*

October 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2019

Medicare News -- October 2019

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Medicare News -- September 2019

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Coming soon: Electronic attachments

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Changes to prior authorization (PA) requirements

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News - Ohio Medicare Sep 1, 2019

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- September 2019

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.
September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Reminder: Changes to timely filing requirements coming in October

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Provider Transparency Update

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Anthem launches Sydney on September 1; new app offers better digital health care support to members

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

PCP after-hours access requirements

September 2019 Anthem Provider News - Ohio Administrative Sep 1, 2019

Clinical criteria and prior authorization updates for specialty pharmacy are available*

September 2019 Anthem Provider News - Ohio Pharmacy Sep 1, 2019

Access requirements for behavioral health care services

September 2019 Anthem Provider News - Ohio Behavioral Health Sep 1, 2019

Clinical Guideline Updates -- September 2019*

September 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Sep 1, 2019

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

August 2019 Anthem Provider News - Ohio Pharmacy Aug 1, 2019

Pharmacy information available at anthem.com

August 2019 Anthem Provider News - Ohio Pharmacy Aug 1, 2019

Medical Policy and Clinical Guideline Updates -- August 2019*

August 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2019

Anthem customizations to MCG care guidelines 23rd edition*

August 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2019
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