Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 31, 2023

June 2023 Provider Newsletter

Featured Articles

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 31, 2023

Introducing Roster Automation to improve turnaround times and data accuracy

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Correction: Federal Employee Program® Quality Reimbursement program update


Administrative

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 24, 2023

Help your patients stay covered

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2023

Consider a FIT kit for your patients aged 45 and older at average risk for colon cancer

AdministrativeAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

CAA: Have you reviewed your online provider directory information lately?

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 12, 2023

Anthem HealthKeepers Plus Electronic Visit Verification for Home Health

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 31, 2023

Electronic Visit Verification – FAQ

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Digital notifications are coming June 1, 2023

Education & Training

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 31, 2023

Provider orientation and training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 31, 2023

Building Vaccine Confidence – A webinar hosted by Pfizer

Guideline Updates

Guideline UpdatesAnthem Blue Cross and Blue Shield | CommercialMay 19, 2023

MCG Care Guidelines 27th Edition

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 4, 2023

Clinical Criteria Updates December 2022

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 11, 2023

Clinical Criteria Updates February 2023

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 31, 2023

MCG Care Guidelines 27th Edition

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 2, 2023

Clinical Criteria Updates for December 2022

Guideline UpdatesAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Clinical Criteria updates for specialty pharmacy are available

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 2, 2023

MCG Care Guidelines 27th edition

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 16, 2023

Updates to Carelon Medical Benefits Management, Inc. advanced imaging, sleep disorder management, and spine surgery Clinical Appropriateness Guidelines

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 23, 2023

Transition to Carelon Medical Benefits Management, Inc. MRI Breast Clinical Appropriateness Guidelines

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 18, 2023

Medical Policies and Clinical Utilization Management Guidelines update

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 31, 2023

Updates to Carelon Medical Benefits Management, Inc. Advanced Imaging and Sleep Disorder Management Clinical Appropriateness Guidelines

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 31, 2023

Medicare Part B Step Therapy Vegzelma

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 31, 2023

Medicare Part B Precert Expansion Briumvi Leqembi

Prior AuthorizationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 24, 2023

Prior Authorization Requirement Changes Effective July 1, 2023

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Effective August 1, 2023, Carelon Medical Benefits Management, Inc. programs will expand

Prior AuthorizationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 23, 2023

Prior Authorization Update for Briumvi, Elahere, Imjudo, Leqembi, Pedmark, Sunlenca, Tecvayli, Tzield

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Precertification list change notification for Virginia for September 1, 2023

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Retraction: May 2023 reimbursement policy updates

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Expansion of Back Pain Guide Program effective July 1, 2023

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialMay 31, 2023

OBRA 93 claim filing for Federal Employee Program

PharmacyAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2023

Pharmacy information available on our provider website

PharmacyAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

BioPlus provider FAQ

PharmacyAnthem Blue Cross and Blue Shield | CommercialMay 31, 2023

Specialty pharmacy updates – June 2023

Quality Management

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 31, 2023

Patient Safety Skilled Nursing Facility (SNF) Survey

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 2, 2023

Colorectal Cancer Screening (COL) and Care for Older Adults (COA) for HEDIS

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 22, 2023

SPC Exclusions

VABCBS-CDCRCM-024900-23

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

* Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan. BioPlus Specialty Pharmacy is an independent company providing pharmacy services on behalf of the health plan.