Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

July 2024 Provider Newsletter

Featured Articles

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

Admission, discharge, and transfer information is now available for Medicare Advantage and Medicaid members


Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Anesthesia modifiers — professional editing update

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Provider contract notifications via Availity Essentials

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Timely receipt of other carrier EOB or rejection helps avoid timely filing denials

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

Anatomical modifiers

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2024

Virginia Accredited Office Surgery Program and upcoming program amendment

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

CAA: Maintain your online provider directory information

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJune 18, 2024

Phoenix Sepsis Criteria for coding and billing pediatric sepsis

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialJune 20, 2024

Digital-only authorization case status notification coming to you

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Adopting digital member ID cards

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialJune 13, 2024

Faster notification of EDI corrected claims errors

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

Provider orientation and training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

July is Disability Awareness Month

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialMarch 12, 2024

Important reminder: The correct original claim number must be included if submitting a corrected claim

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJuly 1, 2024

Person-centered thinking hybrid training

Guideline Updates

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 29, 2024

Clinical Criteria updates

Effective June 29, 2024

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 4, 2024

Clinical Criteria updates

Effective July 6, 2024

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 3, 2024

Clinical Criteria updates — November 2023

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJune 4, 2024

Carelon Medical Benefits Management, Inc. updates

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 29, 2024

Carelon Medical Benefits Management, Inc. updates

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 27, 2024

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

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 22, 2024

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

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Coding update effective October 1, 2024

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Coverage and Clinical Guidelines update (effective October 1, 2024)

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 30, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective July 1, 2024

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 30, 2024

MCG Care Guidelines 28th edition

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialJune 19, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Precertification list change notification July 1, 2024

Prior AuthorizationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJune 20, 2024

Prior authorization requirement changes effective August 1, 2024

Code C9790

Prior AuthorizationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJune 11, 2024

Prior authorization requirement changes

Effective August 1, 2024
Codes 81173, 81247, 81249, 81307, 81336, 81403, 81405, and 81440

Products & Programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Antidepressant Medication Management (AMM)

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJune 18, 2024

Prior authorization updates for medications billed under the medical benefit

PharmacyAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2024

Specialty pharmacy updates — July 2024

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 20, 2024

Anthem expands specialty pharmacy precertification list

Quality Management

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2024

Understanding your role in the Health Outcomes Survey

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