CommercialMarch 1, 2021

March 2021 Anthem Provider News - Ohio

Administrative

AdministrativeCommercialMarch 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - March 2021
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.

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMarch 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery guideline

Medical Policy & Clinical GuidelinesCommercialMarch 1, 2021

Anthem clarifies guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNFs)*
*Material Adverse Change (MAC)

Reimbursement PoliciesCommercialMarch 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

Products & Programs

PharmacyCommercialMarch 1, 2021

Updates for specialty pharmacy are available - March 2021*
*Material Adverse Change (MAC)

State & Federal

State & FederalMedicare AdvantageMarch 1, 2021

Medicare News - March 2021
View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers

State & FederalMedicare AdvantageMarch 1, 2021

Access to more claim denial information is now self-service

State & FederalMedicare AdvantageMarch 1, 2021

New provider directory indicator for telehealth services

State & FederalMedicare AdvantageMarch 1, 2021

Medical policies and clinical utilization management guidelines update