CommercialDecember 1, 2021

December 2021 Anthem Provider News - Ohio

Administrative

AdministrativeCommercialDecember 1, 2021

Updated BlueCard® provider manual available

AdministrativeCommercialDecember 1, 2021

Professional system updates for 2022

AdministrativeCommercialDecember 1, 2021

Outpatient system updates for 2022

AdministrativeCommercialDecember 1, 2021

Behavioral healthcare appointment access requirements

AdministrativeCommercialDecember 1, 2021

Importance of PCP after-hours messaging

AdministrativeCommercialDecember 1, 2021

Important information about utilization management

AdministrativeCommercialDecember 1, 2021

Case management program

AdministrativeCommercialDecember 1, 2021

Member rights and responsibilities

AdministrativeCommercialDecember 1, 2021

Coordination of care

Digital SolutionsCommercialDecember 1, 2021

Submitting prior authorizations is getting easier
Anthem is transitioning to the Availity Authorization app

Digital SolutionsCommercialDecember 1, 2021

Is prior authorization required?
Answering your questions about the new Availity Authorization App

Digital SolutionsCommercialDecember 1, 2021

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers
EnrollSafe replaced CAQH Enrollhub effective November 1, 2021

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2021

Medical policy and clinical guideline updates - December 2021*
*Notice of Material Amendment/Change to Contract (MAC)

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2021

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline*
*Notice of Material Amendment/Change to Contract (MAC)

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines*
*Notice of Material Amendment/Change to Contract (MAC)

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*
*Notice of Material Amendment/Change to Contract (MAC)

Medical Policy & Clinical GuidelinesCommercialDecember 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline*
*Notice of Material Amendment/Change to Contract (MAC)

Reimbursement PoliciesCommercialDecember 1, 2021

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

Reimbursement PoliciesCommercialDecember 1, 2021

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*
*Notice of Material Amendment/Change to Contract (MAC)

Reimbursement PoliciesCommercialDecember 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*
*Notice of Material Amendment/Change to Contract (MAC)

Reimbursement PoliciesCommercialDecember 1, 2021

Reimbursement policy update: Virtual Visits - Professional and Facility

Products & Programs

Products & ProgramsCommercialDecember 1, 2021

Company to retire Blue Precision program on December 31, 2021

Products & ProgramsCommercialDecember 1, 2021

Updated AIM musculoskeletal program site of care reviews delayed

PharmacyCommercialDecember 1, 2021

Specialty pharmacy updates - December 2021*
*Notice of Material Amendment/Change to Contract (MAC)

PharmacyCommercialDecember 1, 2021

Pharmacy information available at anthem.com

State & Federal

State & FederalMedicare AdvantageDecember 1, 2021

Keep up with Medicare News - December 2021
  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)

State & FederalMedicare AdvantageDecember 1, 2021

2022 Medicare Advantage service area and benefit updates

State & FederalMedicare AdvantageDecember 1, 2021

Reimbursement policy update: Drug screen testing

State & FederalMedicare AdvantageDecember 1, 2021

Good news: Non-payment remittance advice enhancements are here

State & FederalMedicare AdvantageDecember 1, 2021

Submitting prior authorizations is getting easier

State & FederalMedicare AdvantageDecember 1, 2021

Somatus is your resource for kidney care management