Ohio
Provider Communications

September 2019 Anthem Provider News - Ohio

Download as PDF

Title Category

Reminder: Changes to timely filing requirements coming in October

Administrative

Provider Transparency Update

Administrative

Pharmacy benefit manager change to IngenioRx

Medicare

PCP after-hours access requirements

Administrative

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

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

Reimbursement Policies

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

Reimbursement Policies

Medicare News -- September 2019

Medicare

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare

Coming soon: Electronic attachments

Medicare

Clinical Guideline Updates -- September 2019*

Medical Policy & Clinical Guidelines

Clinical Criteria updates

Medicare

Clinical criteria and prior authorization updates for specialty pharmacy are available*

Pharmacy

Claims requiring additional documentation facility reimbursement policy update

Administrative

Claim editing update for Excludes1 notes

Reimbursement Policies

Changes to prior authorization (PA) requirements

Medicare

Anthem launches Sydney on September 1; new app offers better digital health care support to members

Administrative

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

Administrative

Access requirements for behavioral health care services

Behavioral Health
Page 1 of 1