Ohio
Provider Communications

December 2021 Anthem Provider News - Ohio

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Title Category

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Administrative

Updated BlueCard® provider manual available

Administrative

Professional system updates for 2022

Administrative

Outpatient system updates for 2022

Administrative

Chlamydia is asymptomatic. Only through screening will we know for sure

Administrative

Behavioral healthcare appointment access requirements

Administrative

Importance of PCP after-hours messaging

Administrative

Important information about utilization management

Administrative

Case management program

Administrative

Member rights and responsibilities

Administrative

Coordination of care

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Submitting prior authorizations is getting easier

Anthem is transitioning to the Availity Authorization app
Digital Tools

Is prior authorization required?

Answering your questions about the new Availity Authorization App
Digital Tools

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021
Digital Tools

Company to retire Blue Precision program on December 31, 2021

Products & Programs

Updated AIM musculoskeletal program site of care reviews delayed

Products & Programs

Specialty pharmacy updates - December 2021*

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

Pharmacy information available at anthem.com

Pharmacy

Medical policy and clinical guideline updates - December 2021*

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

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline*

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

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines*

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

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

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

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline*

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

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

Reimbursement Policies

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*

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

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*

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

Reimbursement policy update: Virtual Visits - Professional and Facility

Reimbursement Policies

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)
Medicare

2022 Medicare Advantage service area and benefit updates

Medicare

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

Medicare

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medicare

Reimbursement policy update: Drug screen testing

Medicare

Good news: Non-payment remittance advice enhancements are here

Medicare

Submitting prior authorizations is getting easier

Medicare

Somatus is your resource for kidney care management

Medicare
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