Virginia
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Update to the Pregnancy Notification Form

December 2022 Anthem Provider News - Virginia Medicaid Dec 1, 2022

Doula services

December 2022 Anthem Provider News - Virginia Medicaid Dec 1, 2022

Keep up with Medicaid news: December 2022

  • Medical drug benefit Clinical Criteria updates
  • Medical Policies and Clinical Utilization Management Guidelines update
  • Prior authorization updates for medications billed under the medical benefit (Releuko, Vabysmo)
  • Prior authorization requirement changes effective January 1, 2023
December 2022 Anthem Provider News - Virginia Medicaid Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Anthem Provider News - Virginia Medicare Dec 1, 2022

Keep up with Medicare news: December 2022

  • Medical drug benefit Clinical Criteria updates
  • Medical Policies and Clinical Utilization Management Guidelines update
December 2022 Anthem Provider News - Virginia Medicare Dec 1, 2022

Personal home helper benefit ending

December 2022 Anthem Provider News - Virginia Medicare Dec 1, 2022

Important information about utilization management

November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Remote EMR access service for HEDIS

November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Important information about utilization management

November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Guidance for coding evaluation and management services for new and established patients

November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Retraction of policy: Private duty nursing reimbursement

November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Keep up with Medicaid news: November 2022

  • Prior authorization requirement changes effective November 1, 2022
  • Medical drug benefit Clinical Criteria updates
November 2022 Anthem Provider News - Virginia Medicaid Nov 1, 2022

Keep up with Medicare news: November 2022

  • New specialty pharmacy medical step therapy requirements
  • New specialty pharmacy medical step therapy requirements
  • Medical drug benefit Clinical Criteria updates
November 2022 Anthem Provider News - Virginia Medicare Nov 1, 2022

Personalized Match

November 2022 Anthem Provider News - Virginia Medicare Nov 1, 2022

Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

November 2022 Anthem Provider News - Virginia Medicare Nov 1, 2022

Availity Essentials provider chat: A fast, easy way to get your utilization management questions answered for Federal Employee members

October 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Oct 1, 2022

Complex Case Management program

October 2022 Anthem Provider News - Virginia Medicaid Oct 1, 2022

Members’ Rights and Responsibilities section

October 2022 Anthem Provider News - Virginia Medicaid Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing – Professional

October 2022 Anthem Provider News - Virginia Medicaid Oct 1, 2022

Monkeypox resources and recommendations for our care providers

October 2022 Anthem Provider News - Virginia Medicaid Oct 1, 2022

Keep up with Medicaid news: October 2022

  • New specialty pharmacy medical step therapy requirements
  • Prior authorization updates for medications billed under the medical benefit – effective December 1, 2022
  • Prior authorization updates for medications billed under the medical benefit – effective November 1, 2022
  • Private duty nursing reimbursement
  • Change to DME canes, crutches, and walkers benefit limits
  • Change to DME traction equipment
October 2022 Anthem Provider News - Virginia Medicaid Oct 1, 2022

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency FAQ

October 2022 Anthem Provider News - Virginia Medicare Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

October 2022 Anthem Provider News - Virginia Medicare Oct 1, 2022

Reimbursement policy retraction: Sexually transmitted infections testing - professional

October 2022 Anthem Provider News - Virginia Medicare Oct 1, 2022

Keep up with Medicare news: October 2022

  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list – J3490, J3590 and J3299
  • Consultation codes
October 2022 Anthem Provider News - Virginia Medicare Oct 1, 2022

OBRA 93 claim filing for Federal Employee Program

September 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Sep 1, 2022

Reimbursement policy update - Modifiers 25 and 57: Evaluation and Management with Global Procedures

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

New specialty pharmacy medical step therapy requirements

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Provider Services Solution enrollment for MCO-only providers

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Help your pregnant patients quit smoking

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Clinical Laboratory Improvement Amendments

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Alcohol use disorders linked to chronic diseases

September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Keep up with Medicaid news: September 2022

  • Clinical Criteria updates
  • Updates for medication codes billed under the medical benefit
  • Nursing facility admissions and LTSS screenings
  • July 2022 HCBS rate increase notice
September 2022 Anthem Provider News - Virginia Medicaid Sep 1, 2022

Prior authorization requirement changes effective December 1, 2022

September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

Reimbursement policy update - Modifiers 25 and 57: Evaluation and Management with Global Procedures

September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

Reminder: AIM prior authorization phone number change for Medicare

September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

Keep up with Medicare news: September 2022

  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
September 2022 Anthem Provider News - Virginia Medicare Sep 1, 2022

HEDIS 2022: Summary of changes from the National Committee for Quality Assurance

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Using screening, brief intervention, and referral to treatment to address opioid and substance use disorders

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

The cost of alcohol use disorder

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Prior authorization requirement changes updated effective November 1, 2022

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Chlamydia screening

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Billing taxonomy code requirements

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Service facilitation visit authorization and limit reminder

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Treatment involving prescription of opioids

August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Keep up with Medicaid news: August 2022

  • One-time COVID-19 Support Payment for Attendant/Aides
August 2022 Anthem Provider News - Virginia Medicaid Aug 1, 2022

Keep up with Medicare news: August 2022

  • MCG care guidelines 26th edition
August 2022 Anthem Provider News - Virginia Medicare Aug 1, 2022

Radiology prior authorization review transitioned to AIM; prior authorization required

July 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Jul 1, 2022

Prior authorization requirement changes effective August 1, 2022

July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

Antibiotic dispensing guidelines

July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

Update use of modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

Change to Department of Medical Assistance Services’ incontinence undergarment benefit limits

July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

Keep up with Medicaid news: July 2022

  • Updating member information
  • Use of Imaging Studies for Low Back Pain (LBP)
  • Remote patient monitoring update
  • Prior authorization updates for medications billed under the medical benefit
  • Virginia Medicaid language interpretation services
July 2022 Anthem Provider News - Virginia Medicaid Jul 1, 2022

Update use of modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Anthem Provider News - Virginia Medicare Jul 1, 2022

Cancer Care Navigator

July 2022 Anthem Provider News - Virginia Medicare Jul 1, 2022

Keep up with Medicare news: July 2022

  • New specialty pharmacy medical step therapy requirements
July 2022 Anthem Provider News - Virginia Medicare Jul 1, 2022

Process change for Federal Employee Program® third-party correspondence requests

June 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Anthem Provider News - Virginia Medicaid Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Anthem Provider News - Virginia Medicaid Jun 1, 2022

Medical drug benefit Clinical Criteria updates

June 2022 Anthem Provider News - Virginia Medicaid Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Anthem Provider News - Virginia Medicaid Jun 1, 2022

Keep up with Medicaid news: June 2022

  • Transcranial magnetic stimulation provider communication
  • Prior authorization update for select durable medical equipment (DME) items
  • MES and DMAS enrollment requirement
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • Prior authorization updates for medications billed under the medical benefit
  • Precertification requirement notice
June 2022 Anthem Provider News - Virginia Medicaid Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Medical drug benefit Clinical Criteria updates

June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Keep up with Medicare news: June 2022

  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • New specialty pharmacy medical step therapy requirements
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
June 2022 Anthem Provider News - Virginia Medicare Jun 1, 2022

Federal Employee Program® AIM radiology prior authorization review reminder

May 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) May 1, 2022

CORRECTION: Save time by using CPT II codes: Introducing FEP® Quality Reimbursement Program for PPO providers

May 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) May 1, 2022

Join us for a FEP® Quality Learning Program live webinar

Everything you need to know about using CPT II Codes
May 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Anthem Provider News - Virginia Medicaid May 1, 2022

Personal care services prior authorization change

May 2022 Anthem Provider News - Virginia Medicaid May 1, 2022

Keep up with Medicaid news: May 2022

  • DMAS MEMO: Medicaid Enterprise System
  • Prior authorization requirement change for HCPCS code K1022
  • New specialty pharmacy medical step therapy requirements
May 2022 Anthem Provider News - Virginia Medicaid May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Provider News - Virginia Medicare May 1, 2022

HEDIS 2022: Summary of changes from the National Committee for Quality Assurance

May 2022 Anthem Provider News - Virginia Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements

May 2022 Anthem Provider News - Virginia Medicare May 1, 2022

Keep up with Medicare news: May 2022

  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list effective July 1, 2022
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • New specialty pharmacy medical step therapy requirements effective June 1, 2022
May 2022 Anthem Provider News - Virginia Medicare May 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

Claims reprocessing update for home- and community-based services

April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

Reminder: Provider orientations are available

April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

Keep up with Medicaid news: April 2022

  • Prior authorization updates for medications billed under the medical benefit
  • Medical drug benefit Clinical Criteria updates
  • Improving the lives of our members: Social drivers of health
  • Medical Policies and Clinical Utilization Management Guidelines update
April 2022 Anthem Provider News - Virginia Medicaid Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

Model of Care required training

April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

The impact of listening

April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

Keep up with Medicare news: April 2022

  • Medical Policies and Clinical Utilization Management Guidelines update
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
April 2022 Anthem Provider News - Virginia Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date.  Read important information about this change.

Transition to NYC Medicare Advantage Plus Delayed Medicare Mar 15, 2022

Change to the Federal Employee Program® clinical grievance and appeal address

March 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Mar 1, 2022

HEDIS 2022 Federal Employee Program® medical record request requirements

March 2022 Anthem Provider News - Virginia Federal Employee Plan (FEP) Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Anthem Provider News - Virginia Medicaid Mar 1, 2022

It is CAHPS survey time

March 2022 Anthem Provider News - Virginia Medicaid Mar 1, 2022
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