CommercialAugust 1, 2020

August 2020 Anthem Provider News - Ohio

Administrative

AdministrativeCommercialAugust 1, 2020

Notice of material changes/amendments to contract and prior authorization changes - August 2020
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.
- Anthem prior authorization updates for specialty pharmacy are available-August 2020*
- Medical Policy and Clinical Guideline Updates-August 2020*
- Expansion of AIM Musculoskeletal Program effective November 1, 2020*
- Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

AdministrativeCommercialAugust 1, 2020

Provider contract and fee schedule notifications coming soon

AdministrativeCommercialAugust 1, 2020

Resources to support diverse patients and communities

AdministrativeCommercialAugust 1, 2020

Evaluation and management services correct coding (Professional)

AdministrativeCommercialAugust 1, 2020

Migrate your EDI transactions to Availity today

AdministrativeCommercialAugust 1, 2020

Anthem electronic attachments - X12 275 5010

AdministrativeCommercialAugust 1, 2020

Medical record standards

Policy Updates

Medical Policy & Clinical GuidelinesCommercialAugust 1, 2020

Medical policy and clinical guideline updates - August 2020*

Medical Policy & Clinical GuidelinesCommercialAugust 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020*

State & Federal

State & FederalMedicare AdvantageAugust 1, 2020

Medicare News - August 2020
View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition

State & FederalMedicare AdvantageAugust 1, 2020

Medical drug benefit clinical criteria updates

State & FederalMedicare AdvantageAugust 1, 2020

2020 Medicare risk adjustment provider trainings