Ohio
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Clinical criteria updates notification - November 2020

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Clinical criteria updates notification - December 2020

April 2021 Anthem Provider News - Ohio Medicare Apr 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Medical policies and clinical utilization management guidelines update

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Ohio Medicare Mar 1, 2021

PN for UM AROW Item 1330

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Ohio Medicare Feb 1, 2021

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2021

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

2020 Medicare risk adjustment provider trainings

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Joint announcement to end delegation in Ohio

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Pilkington North America, Inc. offers Medicare Advantage option

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

2021 Medicare Advantage individual benefits and formularies

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Medical policies and clinical utilization management guidelines update

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Policy Update: Emergency Department: Leveling of Evaluation and Management Services

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Ohio Medicare Dec 1, 2020

Medicare News - November 2020

View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed
November 2020 Anthem Provider News - Ohio Medicare Nov 1, 2020

Provider Chat: A fast, easy way to get your questions answered

November 2020 Anthem Provider News - Ohio Medicare Nov 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Ohio Medicare Nov 1, 2020

FDA approvals and expedited pathways used - new molecular entities

November 2020 Anthem Provider News - Ohio Medicare Nov 1, 2020

Federal Employee Program® expands specialty pharmacy prior authorization list*

October 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2020

Medicare News - October 2020

View these Medicare articles:
- Evaluation and management services correct coding
- Medical policies and clinical utilization management guidelines update
- Prior authorization requirements for the below codes effective January 2021
October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Medical drug benefit clinical criteria updates

October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Prior authorization requirements for the below codes effective January 1, 2021

October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Social determinants of health support expanding with GroundGame Health

October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Provider transparency update

October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Anthem Provider News - Ohio Medicare Oct 1, 2020

Update: Notice of changes to the AIM musculoskeletal program

September 2020 Anthem Provider News - Ohio Medicare Sep 1, 2020

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Ohio Medicare Sep 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
August 2020 Anthem Provider News - Ohio Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Ohio Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News - Ohio Medicare Aug 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jul 1, 2020

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

2020 affirmative statement concerning utilization management decisions

July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

In-Office Assessment Program

July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News - Ohio Medicare Jul 1, 2020

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News - Ohio Medicare May 1, 2020

Trusted Senior Care Advantage - a delegated provider for southeastern Ohio Medicare Advantage membership

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Greater Dayton Senior Care Advantage - a delegated provider for Dayton, OH Medicare Advantage membership

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

HEDIS 2020 Federal Employee Program® medical record request requirements

April 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Apr 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medicare News - April 2020

View these Medicare notices:
- Coding tip for psychological and neuropsychological testing
- Medical Policies and Clinical Utilization Management Guidelines update
- New Medicare Advantage opioid treatment Program benefit
- Prior authorization requirements: new 2020 codes for coverage and precertification
April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Medical drug benefit Clinical Criteria updates - December 2019

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Updated COVID-19 Medicare Information

For the latest COVID-19 Medicare information, please check Medicare Advantage Provider News Archives.
COVID-19 Information - Ohio Medicare Mar 25, 2020

Medicare News - March 2020

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Outpatient Rehabilitation Program transition: new prior authorization requirements

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Complex discharge planning

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Personal Home Helper benefit

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Reminder: Mid-level practitioners are required to file using their NPI

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Non-preferred products and corresponding preferred alternatives

March 2020 Anthem Provider News - Ohio Medicare Mar 1, 2020

Medicare News - February 2020

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

Reimbursement Policy Update: Modifier 62: Co-Surgeons

February 2020 Anthem Provider News - Ohio Medicare Feb 1, 2020

Medicare News -- January 2020

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Postponed -- Review of professional claims with emergency room level 5 E/M codes

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Ohio IAM Local 2848 Retiree VEBA moves to Medicare Advantage plan under Anthem

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

2020 FEP® Benefit information available online

January 2020 Anthem Provider News - Ohio Federal Employee Plan (FEP) Jan 1, 2020

Introducing ConcertoHealth

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Electric Boat offers Medicare Advantage options

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

2020 Medicare risk adjustment provider trainings

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Medicare preferred continuous glucose monitors

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

August 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

September 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Provider News - Ohio Medicare Jan 1, 2020

Group Retiree Solutions Kentucky and Ohio HMO Medicare Advantage plans

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

State Auto Insurance Companies to offer Medicare Advantage option

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Coordination of benefits for an FEP® member

December 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Dec 1, 2019

Medicare News -- December 2019

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Provider training series

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Reminder to Medicare Advantage providers

December 2019 Anthem Provider News - Ohio Medicare Dec 1, 2019

Medicare News -- November 2019

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Ohio Medicare Nov 1, 2019

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review*

October 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2019
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