Virginia
Provider Communications

Important COVID-19 update: Prior authorization and other policy adjustments (Updated January 18, 2022)

New Medicare Advantage plan will have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing Providers Nationally

Effective April 1, 2022, approximately 200,000 Medicare-eligible City of New York retirees across the United States will transition to the NYC Medicare Advantage Plus plan and have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

Well-child visits: Know the numbers

Is prior authorization required? Use the Availity Authorization app

Submitting prior authorizations is getting easier

Coverage guidelines effective April 1, 2022

2022 FEP® Benefit information available online

Botox® update for Anthem HealthKeepers Plus members

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

2021 CAHPS Survey results

Submitting prior authorizations is getting easier

Keep up with Medicaid news: January 2022

• Provider orientations and training
• Prior authorization updates for medications billed under the medical benefit effective March 1, 2022
• Prior authorization updates for medications billed under the medical benefit
• AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
• Change to durable medical equipment wheelchair benefit limits
• HEDIS Guide for retinal exam using fundoscopic photograph

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

Important update on Botox® for Medicare members of Anthem Blue Cross and Blue Shield

Volvo Group North American offers Medicare Advantage option

Availity authorization app available to Anthem Blue Cross and Blue Shield providers in 2022

Keep up with Medicare news: January 2022

• Medical step therapy updates
• Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
• AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update

Information from Anthem for Care Providers about COVID-19 (Updated December 30, 2021)

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Professional system updates for 2022

Outpatient system updates for 2022

Chlamydia is asymptomatic; Only through screening will we know for sure

Importance of primary care physician after-hours messaging

Important information about utilization management

Case Management Program

Coordination of care

Member rights and responsibilities

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

Clinical practice and preventive health guidelines available on anthem.com

Company to retire Blue Precision program on December 31, 2021

Behavioral healthcare appointment access requirements

Specialty pharmacy updates effective March 1, 2022

Anthem clinical criteria updates for specialty pharmacy are available

Pharmacy information available on anthem.com

Reimbursement policy update: Drug Screen Testing

HEDIS measures: Follow-up after ED visits for mental illness and alcohol and drug dependency

Healthy Rewards reminder for providers

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medical Policies and Clinical Utilization Management Guidelines update

Change to durable medical equipment wheelchair benefit limits

Non-payment remittance advice enhancements

Keep up with Medicaid news: December 2021

• Durable medical equipment prior authorization requirement changes effective December 1, 2021
• Prior authorization requirement changes
• Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
• Medical drug benefit Clinical Criteria updates
• Important information regarding behavioral health project BRAVO implementation
• Home delivery pharmacy reminder

Non-payment remittance advice enhancements

Reimbursement policy: Drug screen testing

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

2022 Medicare Advantage service area and benefit updates

Keep up with Medicare news: December 2021

• Updates to AIM Specialty Health musculoskeletal interventional pain management
  clinical appropriateness guideline
• Medical drug benefit Clinical Criteria updates
• Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
• New York City Medicare Advantage announcement
• Medical Policies and Clinical Utilization Management Guidelines update

Register today for a forum on Grief and Loss: The disproportionate impact of the pandemic on communities of color

Include referring provider name and NPI on home infusion therapy and ambulatory infusion suite professional claims

Change in coverage for continuous glucose monitors for some fully insured groups

Time to prepare for HEDIS® medical record review

Reducing the burden of medical record review and improving health outcomes with HEDIS® Electronic Clinical Data Systems reporting

Be Antibiotics Aware: Protect your patients

Surprisingly easy ways to help patients quit smoking cigarettes

Join Anthem in talking about racism and its impact on health and earn continuing education credits

Continuing medical education credits available in 2021 for a variety of clinical quality webinars: Register now

EnrollSafe is available: Our new electronic funds transfer enrollment portal for Anthem providers

Against medical advice discharge physician tracking tool

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - Professional

Update regarding annual wellness visits for health plans compliant with the Affordable Care Act

Blue High Performance Network name changing for 2022

Specialty pharmacy updates are available (effective for dates of service on and after February 1, 2022)

Anthem clinical criteria updates for specialty pharmacy are available

Important update on Botox® for Anthem members

Electronic data interchange process

Clinical Criteria updates

Unspecified diagnosis reminder

4 things you can do to encourage cancer screenings for your women patients

Keep up with Medicaid news: November 2021

• FAQ: New AIM Specialty Health contact center phone number
• Behavioral therapy assessments
• Change to DME incontinence benefit limits
• Prior authorization updates for specialty pharmacy

Medicare Advantage telehealth rural health center and federally qualified health center claims

Electronic data interchange process

Clinical Criteria updates

Anthem Blue Cross and Blue Shield offering Advance Medical Directives program for 2022

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

New York City Medicare Advantage announcement

Keep up with Medicare news: November 2021

• Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

Join The Fenway Institute for a CME webinar about improving your LGBTQIA+ patient interactions

Join a live webinar, “LGBTQIA+ Care: Delivering Trust and Belonging with Every Interaction,” presented by the National LGBTQIA+ Health Education Center at The Fenway Institute. 

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

Submit claims with complete and correct data to avoid claim denials

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management

Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Important COVID-19 update: Prior authorization and other policy adjustments (Updated October 1, 2021)

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

Your recommendation is key to encouraging cancer screenings for your female patients

Are you talking to ALL of your patients about breast cancer screenings?

Looking to earn continuing medical education credits? Register for these on-demand webinars

Clinical appeals

Good news: Non-payment remittance advice enhancements coming soon

Procedure searches in Find Care

REMINDER: EnrollSafe, the new electronic funds transfer enrollment portal for Anthem providers - replacing CAQH Enrollhub effective November 1, 2021

Coverage guidelines effective January 1, 2022

Clinical utilization management guideline update

Specialty pharmacy updates are available

Pharmacy information available on anthem.com

Diabetes testing and screening HEDIS measures

Get your payments faster when you sign up for electronic funds transfer

Prior authorization updates for specialty pharmacy