Ohio
Provider Communications

Articles Month: July 2021

Title Publication Category Date

Register for upcoming August CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET

10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET

6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET

Register Now!

Clinical Quality CME Webinar Series Continues - Ohio Administrative Jul 29, 2021

Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

Register now to learn strategies to help you and your practice improve clinical quality

July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims

July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

Proper coding for in-home monitoring can make a measurable difference for INR

July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

Another mark of the pandemic: An increase in childhood obesity

July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

How to enroll in electronic fund transfer (EFT) for faster remittance

July 2021 Anthem Provider News - Ohio Digital Tools Jul 1, 2021

Electronic claim response files

July 2021 Anthem Provider News - Ohio Digital Tools Jul 1, 2021

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

July 2021 Anthem Provider News - Ohio Digital Tools Jul 1, 2021

Company to retire Blue Precision program at the end of the year

July 2021 Anthem Provider News - Ohio Products & Programs Jul 1, 2021

Reminder: Back Pain Guide program effective July 19, 2021

July 2021 Anthem Provider News - Ohio Products & Programs Jul 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)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Designated specialty pharmacy network updates effective October 1, 2021*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Updates for specialty pharmacy are available - July 2021*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Certain specialty medication prior authorization requests may require additional documentation*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Medical Policy and Clinical Guideline Updates - July 2021*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jul 1, 2021

Reminder: Updated AIM rehabilitative program effective August 1, 2021 - Site of service reviews

July 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jul 1, 2021

New reimbursement policy: Non-patient laboratory services - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

Medicare News - July 2021

View 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
July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Ohio Medicare Jul 1, 2021
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