Virginia
Provider Communications

August 2020 Anthem Provider News - Virginia

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Title Category

Appropriate coding helps provide a comprehensive picture of patients’ health

Products & Programs

Anthem prior authorization updates for specialty pharmacy are available

Pharmacy

Anthem to update formulary lists for Commercial health plan pharmacy benefit

Pharmacy

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

Pharmacy

Anthem clinical criteria updates for specialty pharmacy are available

Pharmacy

REMINDER: Company requires National Drug Code for professional and facility outpatient claims effective September 1, 2020

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Anthem electronic attachments: X12 275 5010

Administrative

Migrate your EDI transactions to Availity today

Administrative

Resources to support diverse patients and communities

Administrative

Interactive Care Reviewer: Anthem’s online prior authorization tool targeting August launch for Federal Employee Program and September launch for Anthem’s Commercial membership

Administrative

Anthem’s fall webinar scheduled for November 12; Register soon

Administrative

Medical record standards

Guideline Updates

Expansion of AIM Musculoskeletal Program effective November 1, 2020

Coverage and Clinical Guidelines

Coverage Guidelines effective November 1, 2020

Coverage and Clinical Guidelines

Injectable substances with related injection services: Professional

Reimbursement Policies

Behavioral health HEDIS® measures messages

Medicaid

Provider data update

Medicaid

Adolescent well-care visits HEDIS measure

Medicaid

Controlling high blood pressure (CBP)

Medicaid

Medical drug benefit Clinical Criteria updates

Medicaid

New MCG Care Guidelines 24th edition

Medicaid

Quarterly pharmacy formulary change notice

Medicaid

DMAS specifications for ER physician non-emergent payment reduction policy

Medicaid

DMAS specifications for readmission payment reduction policy

Medicaid

Keep up with Medicaid news

Medicaid

Medical drug benefit Clinical Criteria updates

Medicare

New MCG Care Guidelines 24th edition

Medicare

2020 Medicare risk adjustment provider trainings

Medicare

AIM Musculoskeletal program expansion

Medicare

Keep up with Medicare news

Medicare
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