CommercialMarch 31, 2023
April 2023 Provider News - Ohio
Administrative
CommercialMarch 31, 2023
CAA: Maintain your online provider directory informationCommercialMarch 31, 2023
Authorizations for post-acute care services for Commercial membersCommercialMarch 31, 2023
Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)*CommercialMarch 31, 2023
Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialMarch 31, 2023
Provider manual updates to become effective July 1, 2023CommercialMarch 31, 2023
Helping to reduce delays when submitting attachmentsCommercialMarch 31, 2023
Medical Oncology Program ProviderPortal case entry enhancementsCommercialMarch 31, 2023
Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
CommercialMarch 31, 2023
Update to Claim Payment Dispute processNotice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
CommercialMedicare AdvantageMedicaid Managed CareMarch 31, 2023
Survey for all skilled nursing facilitiesEducation & Training
Medicaid Managed CareMarch 31, 2023
Ready, set, renew!Policy Updates
CommercialMarch 31, 2023
Genetic Testing claim editsCommercialMarch 31, 2023
Notification Regarding Reimbursement Changes to COVID-19 Vaccine AdministrationNotice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
CommercialMarch 31, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialMarch 31, 2023
Reimbursement policy update: Bundled Services and Supplies - ProfessionalNotice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Products & Programs
CommercialMarch 31, 2023
Let’s VaccinateCommercialMedicare AdvantageMarch 31, 2023
Pay Doctor Bill (provider payment option) - General FAQCommercialMarch 31, 2023
FEP Quality Reimbursement Program updateCommercialMarch 31, 2023
HEDIS 2023 Federal Employee Program medical record request requirementsCommercialMarch 31, 2023
Pharmacy information available on our provider websiteState & Federal
Medicaid Managed CareMarch 31, 2023
Urgent - Is your data current? Provider network management and centralized credentialing from ODMMedicaid Managed CareMarch 31, 2023
Statin Therapy Exclusions for Patients with Cardiovascular Disease/Diabetes HEDIS measuresMedicaid Managed CareMarch 31, 2023
The mental health practitioner hubMedicare AdvantageMarch 31, 2023
E-visitsMedicare AdvantageMarch 31, 2023
Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare AdvantageMedicare AdvantageMarch 31, 2023
Keep up with Medicare News - April 2023- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Imjudo, Pedmark, Tecvayli, Tzield, Vegzelma)
- Blue Cross and Blue Shield expands specialty pharmacy precertification list (Elahere)
- New specialty pharmacy medical step therapy requirements (Avastin, Byooviz, Cimerli, Eylea, Lucentis, Vabysmo)
- Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)
- Clinical Criteria updates
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Visit https://providernews.anthem.com/ohio/publications/april-2023-anthem-provider-news-ohio-1678
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