Jan 1, 2019
• State & Federal / Medicare
Effective, January 1, 2019, Anthem will enter into a provider collaboration agreement with Pioneer Physicians in the Akron Ohio market called Paradigm Senior Care Advantage. Anthem delegated responsibility for medical claims payment, prior authorizations, case management, provider credentialing and inpatient and outpatient utilization management to Paradigm Senior Care Advantage for individual Medicare Advantage HMO members attributed to Pioneer Physicians in Summit, Stark, Portage, Medina, Wayne, Carroll, Columbiana, Tuscarawas, Mahoning, Cuyahoga, Trumbull, Lake and Geauga counties. The delegation will be effective January 1, 2019. Members under this arrangement will have Paradigm Senior Care Advantage
on their member ID card.
Additional information will be available at Important Medicare Advantage Updates at anthem.com/medicareprovider.
January 2019 Anthem Ohio Provider Newsletter