Virginia
Provider Communications

August 2018 Anthem Provider Newsletter -- Virginia

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Title Category

Access standards for PCPs, specialists and behavioral health practitioners in 2018

Administrative

Additional support available for members with rare conditions

Products & Programs

An important reminder from Anthem about home sleep testing with NovaSom

Products & Programs

Anthem accepts prior authorization requests for prescription medications online

Pharmacy

Anthem applies daily morphine equivalent dosing limit

Pharmacy

Anthem engages Availity as our EDI gateway

Behavioral Health

Anthem engages with Alliant Health Solutions

Behavioral Health

Anthem expands specialty pharmacy clinical site of care (level of care) drug list

Pharmacy

Anthem expands specialty pharmacy prior authorization list

Pharmacy

Anthem HealthKeepers Plus coding spotlight — Obesity

Medicaid

Anthem HealthKeepers Plus Member’s Rights and Responsibilities Statement from HealthKeepers, Inc.

Medicaid

Anthem removes drugs from specialty pharmacy clinical site of care (level of care) drug list

Pharmacy

Anthem sponsors webinars about Availity’s EDI gateway services

Products & Programs

Anthem streamlines member identification cards – Use Availity to verify members’ cost shares and benefits at time of service

Administrative

Anthem to enhance automated claim edits for professional claims

Administrative

Anthem to update drug lists supporting commercial health plans

Pharmacy

Avastin – Intravitreal treatment for retinal vascular conditions: Report using HCPCS code C9257

Administrative

Care and Cost Finder – New sort option

Products & Programs

Clinical practice and preventive health guidelines available on the Web

Administrative

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective January 1, 2019

Medicare

Coverage guidelines effective November 1, 2018

Coverage and Clinical Guidelines

Coverage guidelines informational notice

Coverage and Clinical Guidelines

DME providers and physicians: Important wheelchair prior authorization information

Medicare

Electronic Data Interchange migration to Availity

Medicaid

HealthKeepers, Inc. adopts 22nd edition of the MCG care guidelines

Medicaid

Important billing update for professional delivery claims

Administrative

Important information about billing colonoscopy and related anesthesia services

Administrative

Important information about utilization management from HealthKeepers, Inc.

Medicaid

Important Message: A new look is coming to provider communications

Administrative

Keep up with Medicare news

Medicare

Mailing address for Federal Employee Program® paper claims and related correspondence

Federal Employee Plan (FEP)

Member explanation of benefits gets a makeover

Administrative

MyDiversePatients.com addresses health care disparities

Medicare

MyDiversePatients.com – A website to support your diverse patients

Products & Programs

New collaboration with Edgepark for breast pump supply management

Medicaid

New functionality added to Availity’s provider enrollment tool for Virginia

Products & Programs

New pregnancy notification process using Availity’s benefit look-up tool

Products & Programs

New pregnancy notification process using the Availity portal Benefit Look-up tool for Anthem HealthKeepers Plus members

Medicaid

New state legislation prompts changes for reimbursement of physician services during credentialing process

Administrative

Normal newborn diagnosis-related group claims processing update

Medicaid

Orientations and training sessions offered to all providers

Medicaid

Pharmacy information available on anthem.com

Pharmacy

Postpartum outreach initiative

Medicaid

Prior authorization requirements for Cabazitaxel (Jevtana)

Medicaid

Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

Medicaid

Provider transparency update

Products & Programs

Refer to anthem.com for information about health care reform and the exchange

Administrative

Register soon for the last Anthem webinar for 2018 – Scheduled October 10

Administrative

Reimbursement policy: Medical Recalls

Medicaid

Submit PA medication requests electronically; new phone number for Medicare Advantage prescription PAs effective September 1

Medicare

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Products & Programs

Updates to AIM level of care Musculoskeletal Surgery Clinical Appropriateness Guidelines

Products & Programs

Updates to AIM Radiation Oncology Clinical Appropriateness Guidelines

Products & Programs

Vaginal birth after cesarean (VBAC) certified shared decision making aid available on the Web

Administrative
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