Ohio
Provider Communications

January 2021 Anthem Provider News - Ohio

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Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - January 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

IngenioRx introduces new pharmacy network in 2021

Pharmacy

Prior authorization updates for specialty pharmacy are available - January 2021*

Pharmacy

It is almost CAHPS survey time!

Administrative

Evaluation and management changes 2021

Administrative

New Blue HPN® plans go live January 1, 2021

Administrative

Outpatient system updates for 2021 - Facility

Administrative

Professional system updates for 2021

Administrative

New features added to Interactive Care Reviewer

Administrative

Procedure searches in Find Care: New sort option

Administrative

Availity attachment tools for Anthem and affiliate payers - Live webinars

Administrative

Self-service, digital transactions are fast and easy

Administrative

Medical Policy and Clinical Guideline Updates - January 2021*

Medical Policy & Clinical Guidelines

MCG Care Guidelines 24th Edition Customization*

Medical Policy & Clinical Guidelines

Anthem implements pilot program for in-network skilled nursing facilities (SNF)

Medical Policy & Clinical Guidelines

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

Reimbursement Policies

Reimbursement policy update: Frequency editing - Professional*

Reimbursement Policies

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

Reimbursement Policies

Reimbursement policy update: Modifier Rules - Professional*

Reimbursement Policies

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

Reimbursement Policies

2021 FEP® benefit information available online

Federal Employee Plan (FEP)

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
Medicare

2020 Medicare risk adjustment provider trainings

Medicare

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

Medicare

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

Medicare

Medical drug benefit clinical criteria updates

Medicare
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