Virginia
Provider Communications

December 2018 Anthem Provider Newsletter - Virginia

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Title Category

2019 FEP® benefit information available online

Federal Employee Plan (FEP)

2019 Medicare Advantage individual benefits and formularies

Medicare

Anthem accepts electronic prior authorization requests for prescription medications online

Pharmacy

Anthem HealthKeepers Plus pharmacy management information

Medicaid

Anthem in Virginia to offer new Exclusive Provider Organization plans beginning January 1, 2019

Administrative

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

Administrative

Availity to serve as EDI entry point for electronic submissions

Administrative

Benefit change for Infliximab for Federal Employee Program

Federal Employee Plan (FEP)

Case Management Program

Products & Programs

Claims system updates for 2019: Professional

Administrative

Clinical practice and preventive health guidelines available on the Web

Coverage and Clinical Guidelines

CMS Medicare Preclusion List effective April 1, 2019

Medicare

Coding spotlight: Substance use disorders and smoking

Medicaid

Company works to simplify payment recovery process for National Accounts membership

Administrative

ConditionCare Program benefits patients and physicians

Products & Programs

Coordination of benefits for FEP® members

Federal Employee Plan (FEP)

Coordination of care

Products & Programs

Coverage Guidelines and Clinical Utilization Management Guidelines update

Medicaid

Coverage guidelines effective March 1, 2019

Coverage and Clinical Guidelines

Electronic data interchange gateway update

Medicaid

Explore new enhancements to the Education and Reference Center

Administrative

HEDIS® 2018 results are in for our Anthem PPO and HealthKeepers commercial products

Products & Programs

Important Information about utilization management

Products & Programs

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

Medicare

Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physicians

Products & Programs

Introducing the new Clinical Criteria page for injectable, infused or implanted drugs

Pharmacy

Keep up with Medicare news

Medicare

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

Medicare

Members’ Rights and Responsibilities

Products & Programs

Misrouted protected health information (PHI)

Administrative

Modifier 79: Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period - Professional

Administrative

MyDiversePatients.com

Medicaid

New autism codes effective January 1, 2019

Administrative

New Medicare Advantage provider service phone number beginning January 1, 2019

Medicare

Orientations and training sessions offered to all providers

Medicaid

Pharmacy information available on anthem.com

Pharmacy

Practitioners’ rights during credentialing process

Medicaid

Precertification requirements reminder

Medicaid

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

Medicaid

Prior authorization requirements for Sublocade

Medicaid

Quality of care review

Medicaid

Quarterly pharmacy formulary change notice

Medicaid

Receive e-mail notifications via our Network eUPDATE

Administrative

Reimbursement policy: Claims requiring additional documentation

Medicaid

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

Coverage and Clinical Guidelines

Update to AIM Clinical Appropriateness Guidelines

Coverage and Clinical Guidelines

Updates on Anthem’s Inmate Medical Services Program

Products & Programs

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

Coverage and Clinical Guidelines

Vaginal Birth after Cesarean (VBAC) Certified shared decision making aid available on the Web

Products & Programs

When and how to initiate Medicare Advantage re-openings

Medicare
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