July 1, 2021
July 2021 Anthem Provider News - Ohio
Filter By: AllCommercial
Administrative
CommercialJuly 1, 2021
Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
Another mark of the pandemic: An increase in childhood obesityCommercialJuly 1, 2021
Proper coding for in-home monitoring can make a measurable difference for INRCommercialJuly 1, 2021
Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claimsCommercialJuly 1, 2021
Register now to learn strategies to help you and your practice improve clinical qualityCommercialJuly 1, 2021
Interactive Care Reviewer (ICR): New search option for cases submitted through ICRCommercialJuly 1, 2021
Electronic claim response filesCommercialJuly 1, 2021
How to enroll in electronic fund transfer (EFT) for faster remittancePolicy Updates
CommercialJuly 1, 2021
Reminder: Updated AIM rehabilitative program effective August 1, 2021 - Site of service reviewsCommercialJuly 1, 2021
Medical Policy and Clinical Guideline Updates - July 2021**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
Reimbursement policy update: Consultations - Professional**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
New reimbursement policy: Non-patient laboratory services - Facility**Notice of Material Amendment/Change to Contract (MAC)
Products & Programs
CommercialJuly 1, 2021
Reminder: Back Pain Guide program effective July 19, 2021CommercialJuly 1, 2021
Company to retire Blue Precision program at the end of the yearCommercialJuly 1, 2021
Updates for specialty pharmacy are available - July 2021**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
Certain specialty medication prior authorization requests may require additional documentation**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
Designated specialty pharmacy network updates effective October 1, 2021**Notice of Material Amendment/Change to Contract (MAC)
CommercialJuly 1, 2021
Update: Site of care medical necessity reviews for long-acting colony-stimulating factors not implemented on June 1, 2021**Notice of Material Amendment/Change to Contract (MAC)
State & Federal
Medicare AdvantageJuly 1, 2021
New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billingMedicare AdvantageJuly 1, 2021
Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021Medicare AdvantageJuly 1, 2021
Medical drug benefit clinical criteria updatesMedicare AdvantageJuly 1, 2021
Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patientsMedicare AdvantageJuly 1, 2021
Let’s VaccinateMedicare AdvantageJuly 1, 2021
Medicare News - July 2021View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
To view this publication online:
Visit https://providernews.anthem.com/ohio/publications/july-2021-anthem-provider-news-ohio-1003
Or scan this QR code with your phone