Ohio
Provider Communications

April 2021 Anthem Provider News - Ohio

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Title Category

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - April 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.
Administrative

The health of millennials: Trends in behavioral health conditions

Behavioral Health

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

Pharmacy

Updates for specialty pharmacy are available - April 2021*

*Notice of Material Amendment/Change to Contract (MAC)
Pharmacy

Pharmacy information available at anthem.com

Pharmacy

COVID fee schedule changes*

*Notice of Material Amendment/Change to Contract (MAC)
Administrative

Updated Provider Manual now available

Administrative

Does your practice offer telehealth services? Let us know!

Administrative

Information Center - Access important policies, forms and helpful resources

Administrative

Understanding Availity roles for electronic data interchange (EDI)

Administrative

Make the change to digital authorization/referral and hospital admission notifications using EDI

Administrative

Attention facilities: Sending admission, discharge and transfer data results in improved care management for patients

Administrative

Chat directly with a prior authorization specialist

Administrative

Keeping up with routine vaccination during COVID-19

Administrative

Interactive bilingual website taking action for our health

Exclusively developed for the Latino Community
Administrative

Join Anthem in talking about racism and its impact on health

Administrative

Medical policy and clinical guideline updates - April 2021*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Update: Clinical guideline adoption postponed*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

MCG Care Guidelines 25th Edition available*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Maximizing efficient, high quality COVID-19 screenings*

*Notice of Material Amendment/Change to Contract (MAC)
Medical Policy & Clinical Guidelines

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

Medical Policy & Clinical Guidelines

New reimbursement policy: Newborn Inpatient Stays for facilities*

*Notice of Material Amendment/Change to Contract (MAC)
Reimbursement Policies

HEDIS 2021 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

Does your practice offer telehealth services? Let us know!

Medicare

In-Office Assessment program

Medicare

Oncology dose reduction program beginning July 1, 2021

Medicare

Clinical criteria updates notification - November 2020

Medicare

Clinical criteria updates notification - December 2020

Medicare
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