Virginia
Provider Communications

September 2019 Anthem Provider News - Virginia

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Title Category

An update about Anthem’s direct contracting effort for NPs and PAs

Administrative

Commercial fee schedule update from Anthem Blue Cross and Blue Shield in Virginia

Administrative

Anthem launches Sydney on September 1; New app offers better digital health care support to members

Administrative

PCP after-hours access requirements

Administrative

Claim editing update for Excludes1 notes

Reimbursement Policies

Misrouted protected health information (PHI)

Administrative

Register today for Anthem’s fall webinar scheduled for October 10

Administrative

Receive important email notifications

Administrative

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019

Coverage and Clinical Guidelines

Clinical practice and preventive health guidelines available on the Web

Guideline Updates

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) audit happening now

Products & Programs

Access requirements for behavioral health care services

Behavioral Health

Clinical Criteria and prior authorization updates for specialty pharmacy are available

Pharmacy

Pharmacy information available on anthem.com

Pharmacy

Prior authorization changes

Medicaid

Evaluation and management services: Over-coded services

Medicaid

Wound care requests

Medicaid

MCG Care Guidelines update and customizations

Medicaid

Medical drug Clinical Criteria updates for first quarter

Medicaid

Medical drug Clinical Criteria updates for second quarter

Medicaid

Medical necessity review for appropriate level of care

Medicaid

Coming soon: Electronic attachments

Medicare

Clinical Criteria updates

Medicare

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare

Changes to PA requirements

Medicare

Pharmacy benefit manager change to IngenioRx

Medicare

Keep up with Medicare news

Medicare
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