April 1, 2019

April 2019 Anthem Provider Newsletter - Ohio

Filter By: AllCommercial

Administrative

AdministrativeCommercialApril 1, 2019

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes: April 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.

AdministrativeCommercialApril 1, 2019

The 2019 Provider Manual is now available for your review

AdministrativeCommercialApril 1, 2019

New on Interactive Care Reviewer (ICR): Request Clinical Appeals

AdministrativeCommercialApril 1, 2019

UM Process Change: Courtesy approval determination notifications

AdministrativeCommercialApril 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

AdministrativeCommercialApril 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

Policy Updates

Medical Policy & Clinical GuidelinesCommercialApril 1, 2019

Medical Policy and Clinical Guidelines Updates - April 2019*

Medical Policy & Clinical GuidelinesCommercialApril 1, 2019

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline*

Medical Policy & Clinical GuidelinesCommercialApril 1, 2019

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines*

Medical Policy & Clinical GuidelinesCommercialApril 1, 2019

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines*

Medical Policy & Clinical GuidelinesCommercialApril 1, 2019

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines*

Reimbursement PoliciesCommercialApril 1, 2019

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

Products & Programs

Products & ProgramsCommercialApril 1, 2019

New AIM Rehabilitative program effective July 1, 2019

PharmacyCommercialApril 1, 2019

Anthem expands specialty pharmacy prior authorization list*

PharmacyCommercialFebruary 1, 2019

Pharmacy information available at anthem.com

State & Federal

State & FederalMedicare AdvantageApril 1, 2019

Update regarding evaluation and management with modifier 25

State & FederalMedicare AdvantageApril 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

State & FederalMedicare AdvantageApril 1, 2019

Keep up with Medicare news - April 2019