Ohio
Provider Communications

Articles Month: March 2023

Title Publication Category Date

Enhanced outpatient facility editing for National Correct Coding Initiative

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Authorizations for post-acute care services for Commercial members

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
April 2023 Provider News - Ohio Administrative Mar 31, 2023

Provider manual updates to become effective July 1, 2023

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)*

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
April 2023 Provider News - Ohio Administrative Mar 31, 2023

CAA: Maintain your online provider directory information

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Helping to reduce delays when submitting attachments

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Medical Oncology Program ProviderPortal case entry enhancements

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Update to Claim Payment Dispute process

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

April 2023 Provider News - Ohio Administrative Mar 31, 2023

Survey for all skilled nursing facilities

April 2023 Provider News - Ohio Digital Tools Mar 31, 2023

Genetic Testing claim edits

April 2023 Provider News - Ohio Policy Updates Mar 31, 2023

Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional

April 2023 Provider News - Ohio Reimbursement Policies Mar 31, 2023

Notification Regarding Reimbursement Changes to COVID-19 Vaccine Administration

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

April 2023 Provider News - Ohio Reimbursement Policies Mar 31, 2023

Bundled Services and Supplies - Professional

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

April 2023 Provider News - Ohio Reimbursement Policies Mar 31, 2023

Pay Doctor Bill (provider payment option) - General FAQ

April 2023 Provider News - Ohio Products & Programs Mar 31, 2023

Let’s Vaccinate

April 2023 Provider News - Ohio Products & Programs Mar 31, 2023

Pharmacy information available on our provider website

April 2023 Provider News - Ohio Pharmacy Mar 31, 2023

HEDIS 2023 Federal Employee Program medical record request requirements

April 2023 Provider News - Ohio Federal Employee Plan (FEP) Mar 31, 2023

FEP Quality Reimbursement Program update

April 2023 Provider News - Ohio Federal Employee Plan (FEP) Mar 31, 2023

Urgent - Is your data current? Provider network management and centralized credentialing from ODM

April 2023 Provider News - Ohio Medicaid Mar 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 Advantage

April 2023 Provider News - Ohio Medicare Mar 31, 2023

E-visits

April 2023 Provider News - Ohio Medicare Mar 31, 2023

Statin Therapy Exclusions for Patients with Cardiovascular Disease/Diabetes HEDIS measures

April 2023 Provider News - Ohio Medicaid Mar 31, 2023

Ready, set, renew!

April 2023 Provider News - Ohio Medicaid Mar 31, 2023

The mental health practitioner hub

April 2023 Provider News - Ohio Medicaid Mar 31, 2023

Keep up with Medicare News - April 2023

- Clinical Criteria Updates
- 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
April 2023 Provider News - Ohio Medicare Mar 31, 2023

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update*

*Notice of Material Amendment/Change to contract (MAC)

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

New policy for EMR clinical data sharing and ADT notifications*

*Notice of Material Amendment/Change to Contract (MAC)
March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

You are invited: Advancing Mental Health Equity for Youth & Young Adults

Register today for the Advancing Mental Health Equity for Youth & Young Adults forum hosted by Anthem Blue Cross and Blue Shield (Anthem) and Motivo* for Anthem providers on March 15, 2023.
March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Reimbursement policy update: Modifiers 25 and 57 - Professional

March 2023 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2023

Specialty pharmacy updates for March 2023*

*Notice of Material Amendment/Change to contract (MAC)

March 2023 Anthem Provider News - Ohio Pharmacy Mar 1, 2023

Member referrals: Employment Services Program and Housing Flex Funds

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Enhancing Provider News website and email communications

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Member ID cards

March 2023 Anthem Provider News - Ohio Medicaid Mar 1, 2023

Keep up with Medicare News - March 2023

- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List in Ohio
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

March is National Colorectal Cancer Awareness Month

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Reminder - Updated Carelon Musculoskeletal Program effective April 1, 2023: monitored anesthesia care reviews

March 2023 Anthem Provider News - Ohio Administrative Mar 1, 2023

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

March 2023 Anthem Provider News - Ohio Products & Programs Mar 1, 2023

Pharmacy information available on our provider website

March 2023 Anthem Provider News - Ohio Pharmacy Mar 1, 2023

Annual planned visits

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Shared savings and transition care management after inpatient discharges

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023

Informational Update Modifier Usage

March 2023 Anthem Provider News - Ohio Medicare Mar 1, 2023
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