Ohio
Provider Communications

December 2020 Anthem Provider News - Ohio

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Title Category

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.
Administrative

Access requirements for behavioral health care services

Behavioral Health

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

Pharmacy

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

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

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

Administrative

Anthem and Quest Diagnostics form strategic relationship

Administrative

Access to claim denial information is now self-service

Administrative

Updated BlueCard® Provider Manual available

Administrative

2-minute videos to engage patients about preventive care

Administrative

Anthem makes going digital easy with the Provider Digital Engagement Supplement

Administrative

Anthem contracted air ambulance providers for Ohio

Administrative

PCP after-hours access requirements

Administrative

Coordination of care

Administrative

Members’ rights and responsibilities

Administrative

Important information about utilization management

Administrative

Case management program

Administrative

Medical policy and clinical guideline updates - December 2020*

Medical Policy & Clinical Guidelines

Anthem expands hospice policy

Medical Policy & Clinical Guidelines

Updates to AIM Cardiology clinical appropriateness guidelines*

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging clinical appropriateness guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Oncology clinical appropriateness guideline*

Medical Policy & Clinical Guidelines

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Clinical practice and preventive health guidelines available on anthem.com

Medical Policy & Clinical Guidelines

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

Reimbursement Policies

2021 Medicare Advantage individual benefits and formularies

Medicare

Joint announcement to end delegation in Ohio

Medicare

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

Medicare

Pilkington North America, Inc. offers Medicare Advantage option

Medicare

Medical policies and clinical utilization management guidelines update

Medicare

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

Medicare

Digital transactions cut administrative tasks in half

Medicare
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