Ohio
Provider Communications

February 2019 Anthem Ohio Provider Newsletter

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Title Category

Anthem expands specialty pharmacy medical step therapy drug list*

Pharmacy

Anthem expands specialty pharmacy prior authorization list*

Pharmacy

Anthem eye refraction and routine eye exam billing information

Medicare

Clinical criteria updates for specialty pharmacy*

Pharmacy

HEDIS 2019 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

HEDIS® 2019: Controlling High Blood Pressure (CBP)

Administrative

Keep up with Medicare news

Medicare

Medical Policy and Clinical Guidelines: February 2019*

Medical Policy & Clinical Guidelines

New specialty Medicare Part B device preferred product program

Medicare

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes: February 2019

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

Pharmacy information available at anthem.com

Pharmacy

Pre-Service/Prior Authorization Clinical Review Update: February 2019*

Medical Policy & Clinical Guidelines

Reimbursement Policy Update: Injectable Substances with Related Injection Services - Professional*

Reimbursement Policies

Reimbursement Policy Updates: February 2019*

Reimbursement Policies

Reminder: Anthem follows Original Medicare policies

Medicare

Reminder: Inpatient commercial claim denials

Administrative

Update regarding E/M with modifier 25 - Professional*

Reimbursement Policies

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Use grouped CPT codes for AIM Specialty Health authorizations

Medicare
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