August 17, 2018

August 2018 Anthem Provider Newsletter -- Virginia

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Important Message: A new look is coming to provider communications

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Member explanation of benefits gets a makeover

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Important billing update for professional delivery claims

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem to enhance automated claim edits for professional claims

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Important information about billing colonoscopy and related anesthesia services

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Clinical practice and preventive health guidelines available on the Web

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

Behavioral Health

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem engages with Alliant Health Solutions

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem engages Availity as our EDI gateway

Guideline Updates

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Coverage guidelines effective November 1, 2018

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Coverage guidelines informational notice

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Additional support available for members with rare conditions

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Care and Cost Finder – New sort option

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

An important reminder from Anthem about home sleep testing with NovaSom

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Provider transparency update

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

MyDiversePatients.com – A website to support your diverse patients

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Updates to AIM level of care Musculoskeletal Surgery Clinical Appropriateness Guidelines

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Updates to AIM Radiation Oncology Clinical Appropriateness Guidelines

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem sponsors webinars about Availity’s EDI gateway services

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem expands specialty pharmacy prior authorization list

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

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

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem accepts prior authorization requests for prescription medications online

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem to update drug lists supporting commercial health plans

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Anthem applies daily morphine equivalent dosing limit

PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 17, 2018

Pharmacy information available on anthem.com

State & Federal

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Anthem HealthKeepers Plus coding spotlight — Obesity

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Reimbursement policy: Medical Recalls

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Normal newborn diagnosis-related group claims processing update

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Prior authorization requirements for Cabazitaxel (Jevtana)

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

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

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

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

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Orientations and training sessions offered to all providers

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Important information about utilization management from HealthKeepers, Inc.

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

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

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Postpartum outreach initiative

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

New collaboration with Edgepark for breast pump supply management

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

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

State & FederalHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 17, 2018

Electronic Data Interchange migration to Availity

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 17, 2018

DME providers and physicians: Important wheelchair prior authorization information

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 17, 2018

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

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 17, 2018

MyDiversePatients.com addresses health care disparities

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 17, 2018

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

State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 17, 2018

Keep up with Medicare news