Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsNovember 1, 2023

November 2023 Provider Newsletter

Featured Articles

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Digital RFAI process improvements

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

Practitioners’ rights during credentialing process


Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2023

New Pathway X Tiered PCP & Hospital Plans for the Individual market beginning January 1, 2024

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Updates to correct coding editing

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Usage of liability modifiers

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 31, 2023

2024 Medicare Advantage service area and benefit updates

AdministrativeAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

CAA: Maintain your online provider directory information

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Improvements to secure messaging through Availity Essentials

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Filing digital claims disputes: Transparent and trackable

Guideline Updates

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Carelon Medical Benefits Management, Inc. updates — November 2023

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 19, 2023

Expansion of Carelon Medical Benefits Management, Inc. programs

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

Prior authorization update - Lamzede, Lunsumio, Rebyota, etc.

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

Precertification list change notification

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 16, 2023

RETRACTION: Prior authorization requirement changes effective February 1, 2024

Codes 32274 and 32275

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialSeptember 28, 2023

Expansion of Carelon Medical Benefits Management, Inc. programs, effective April 1, 2024

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 3, 2023

Prior authorization requirement changes effective February 1, 2024 - code J1411

Products & Programs

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Federal Employee Program specialty pharmacy prior authorization review

Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

FEP® Specialty Pharmacy prior authorization list

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Specialty pharmacy updates

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 31, 2023

Clinical Criteria updates for specialty pharmacy are available

PharmacyAnthem Blue Cross and Blue Shield | CommercialNovember 1, 2023

Pharmacy information available on our provider website

Quality Management

Quality ManagementHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 25, 2023

HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS)

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Controlling high blood pressure and HEDIS

Quality ManagementHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 31, 2023

Controlling high blood pressure and HEDIS

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 27, 2023

Be Antibiotics Aware: Protect your patients

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 25, 2023

HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS)

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 15, 2023

HEDIS medical record submission made easier with our Remote EMR Access Service

Quality ManagementHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 31, 2023

HEDIS medical record submission made easier with our Remote EMR Access Service

Quality ManagementHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 31, 2023

HEDIS measurement year 2023 documentation for Transitions of Care (TRC)

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

HEDIS measurement year 2023 documentation for Transitions of Care (TRC)

Quality ManagementHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 31, 2023

Healthy blood pressure recheck initiative

Quality ManagementAnthem Blue Cross and Blue Shield | Medicare AdvantageNovember 1, 2023

Statin therapy end of year best practices

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