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

October 2024 Provider Newsletter

Featured Articles

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program from Anthem

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 12, 2024

Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracy

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 6, 2024

Changes to special supplemental benefits for the chronically ill eligibility requirements


Administrative

AdministrativeAnthem Blue Cross and Blue Shield | CommercialHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 1, 2024

Mobile crisis response services and crisis receiving center contracting

AdministrativeAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

National Accounts 2025 precertification list

Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 1, 2024

Use Availity Essentials to view authorization case status and set authorization decision notification preference

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

Now live: view your fee schedule in Availity Essentials Payer Spaces

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 6, 2024

Advancing digital efficiency by discontinuing paper remittances

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 4, 2024

Digital Provider Enrollment now available for additional provider types in Availity Essentials

Education & Training

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 23, 2024

Changes to the peer-to-peer and reconsideration processes

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 20, 2024

Ensure timely filing and appeal submissions for claims

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 16, 2024

Seamless advance care: MyDirectives digital tool for D-SNP members

Guideline Updates

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

Clinical Criteria updates

Effective October 4, 2024

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 3, 2024

Clinical Criteria updates

Effective October 6, 2024

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

Coverage and Clinical Guidelines update (effective January 1, 2025)

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 10, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 10, 2024

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

Precertification list change notification, October 1, 2024

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 23, 2024

Prior authorization requirement changes

Effective January 1, 2025

Reimbursement PoliciesAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Reimbursement PoliciesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the Specialty High Performing Provider designation program for commercial networks

Products & ProgramsAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Introduction of the HPP designation program for individual member (Exchange) commercial networks

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageOctober 1, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

PharmacyAnthem Blue Cross and Blue Shield | CommercialSeptember 16, 2024

Specialty pharmacy updates — October 2024

PharmacyAnthem Blue Cross and Blue Shield | CommercialOctober 1, 2024

Pharmacy information available on our provider website

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 9, 2024

Prior authorization updates for medications billed under the medical benefit

Effective November 1, 2024
Alyglo, Simlandi, and Winrevair

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsSeptember 10, 2024

Prior authorization updates for medications billed under the medical benefit

Effective November 1, 2024
Amtagvi, iDoseTR, and Nexobrid

Quality Management

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

Prevent flu and COVID-19: drive the change through vaccination

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

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

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