Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

January 2025 Provider Newsletter

Featured Articles

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsDecember 26, 2024

Availity Essentials maternity update for providers

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 25, 2024

Time to prepare for HEDIS medical record review

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

Introducing Coupe Health — quality care with clear pricing and no upfront payments

Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

New year, new labs: LabCorp and Quest Diagnostics now in‑network for Virginia plans

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

D‑SNP members can earn rewards by participating in select healthcare activities

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

Updates to correct coding editing

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

CAA: Providers required to verify online provider directory information

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

Important updates regarding COVID-19 vaccine and testing policies

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsDecember 30, 2024

Enhance patient coordination with Total Member View

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Guideline Updates

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 6, 2024

Clinical Criteria updates

Effective January 9, 2025

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 4, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective January 5, 2024

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialDecember 26, 2024

Coverage Guidelines and Clinical Guidelines update, April 1, 2025

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsDecember 26, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 19, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Products & Programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialJanuary 1, 2025

2025 FEHB and PSHB information available online

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 23, 2024

Specialty pharmacy precertification list expansion

Effective March 1, 2025

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 31, 2024

Important information about specialty prescriptions

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

Kroger Specialty Pharmacy acquisition

PharmacyAnthem Blue Cross and Blue Shield | CommercialDecember 27, 2024

Weight management program overview

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 23, 2024

Specialty Pharmacy Precertification and Step Therapy list expansion

Effective April 1, 2025

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsDecember 19, 2024

Virginia’s Medicaid Preferred Drug List (PDL)/ Common Core Formulary

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageDecember 16, 2024

Shortage of repackaged bevacizumab for ophthalmic use

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