Ohio
Provider Communications

March 2023 Anthem Provider News - Ohio

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Title Category

Reminder - Updated Carelon Musculoskeletal Program effective April 1, 2023: monitored anesthesia care reviews

Administrative

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

Administrative

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update*

*Notice of Material Amendment/Change to contract (MAC)

Administrative

New policy for EMR clinical data sharing and ADT notifications*

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

You are invited: Advancing Mental Health Equity for Youth & Young Adults

Register today for the Advancing Mental Health Equity for Youth & Young Adults forum hosted by Anthem Blue Cross and Blue Shield (Anthem) and Motivo* for Anthem providers on March 15, 2023.
Administrative

March is National Colorectal Cancer Awareness Month

Administrative

Reimbursement policy update: Modifiers 25 and 57 - Professional

Reimbursement Policies

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

Products & Programs

Pharmacy information available on our provider website

Pharmacy

Specialty pharmacy updates for March 2023*

*Notice of Material Amendment/Change to contract (MAC)

Pharmacy

Member referrals: Employment Services Program and Housing Flex Funds

Medicaid

Enhancing Provider News website and email communications

Medicaid

Member ID cards

Medicaid

Controlling High Blood Pressure and Submitting Compliant Readings

Medicare

Annual planned visits

Medicare

Shared savings and transition care management after inpatient discharges

Medicare

Informational Update Modifier Usage

Medicare

Keep up with Medicare News - March 2023

- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List in Ohio
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
Medicare
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