Virginia
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

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

Annual wellness visits for Medicare Advantage members

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

Pharmacy newsletter

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

Clinical Criteria updates

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

Prior authorization requirement changes effective June 1, 2022

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

Keep up with Medicare news: March 2022

  • Medical step therapy updates
March 2022 Anthem Provider News - Virginia Medicare Mar 1, 2022

Notice of Regulatory Amendment related to Medicaid participating providers and facilities

February 2022 Anthem Provider News - Virginia Medicaid Feb 1, 2022

Reminder: Provider orientations are available

February 2022 Anthem Provider News - Virginia Medicaid Feb 1, 2022

The Behavioral Health Areas of Expertise Profile improves the referral process

February 2022 Anthem Provider News - Virginia Medicaid Feb 1, 2022

Get faster payments with electronic funds transfer

February 2022 Anthem Provider News - Virginia Medicaid Feb 1, 2022

Keep up with Medicaid news: February 2022

  • Provider Services Solution (PRSS)
  • Enrollment and maintenance changes starting April 2022
  • State Memo: December 1, 2021, Behavioral Health Enhancement (BHE) Licensed Services
  • State memo: Important changes to emergency services licenses
  • Cancer Care Navigator
February 2022 Anthem Provider News - Virginia Medicaid Feb 1, 2022

Get faster payments with electronic funds transfer

February 2022 Anthem Provider News - Virginia Medicare Feb 1, 2022

Keep up with Medicare news: February 2022

  • NYC Medicare Advantage Plus update
  • Cancer Care Navigator
February 2022 Anthem Provider News - Virginia Medicare Feb 1, 2022

2022 FEP® Benefit information available online

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

Botox® update for Anthem HealthKeepers Plus members

January 2022 Anthem Provider News - Virginia Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Virginia Medicaid Jan 1, 2022

2021 CAHPS Survey results

January 2022 Anthem Provider News - Virginia Medicaid Jan 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Virginia Medicaid Jan 1, 2022

Keep up with Medicaid news: January 2022

  • Provider orientations and training
  • Prior authorization updates for medications billed under the medical benefit effective March 1, 2022
  • Prior authorization updates for medications billed under the medical benefit
  • AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
  • Change to durable medical equipment wheelchair benefit limits
  • HEDIS Guide for retinal exam using fundoscopic photograph
January 2022 Anthem Provider News - Virginia Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Virginia Medicare Jan 1, 2022

Important update on Botox® for Medicare members of Anthem Blue Cross and Blue Shield

January 2022 Anthem Provider News - Virginia Medicare Jan 1, 2022

Volvo Group North American offers Medicare Advantage option

January 2022 Anthem Provider News - Virginia Medicare Jan 1, 2022

Availity authorization app available to Anthem Blue Cross and Blue Shield providers in 2022

January 2022 Anthem Provider News - Virginia Medicare Jan 1, 2022

Keep up with Medicare news: January 2022

  • Medical step therapy updates
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
January 2022 Anthem Provider News - Virginia Medicare Jan 1, 2022

Reimbursement policy update: Drug Screen Testing

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

HEDIS measures: Follow-up after ED visits for mental illness and alcohol and drug dependency

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Healthy Rewards reminder for providers

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Change to durable medical equipment wheelchair benefit limits

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Non-payment remittance advice enhancements

December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Keep up with Medicaid news: December 2021

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Prior authorization requirement changes
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
  • Medical drug benefit Clinical Criteria updates
  • Important information regarding behavioral health project BRAVO implementation
  • Home delivery pharmacy reminder
December 2021 Anthem Provider News - Virginia Medicaid Dec 1, 2021

Non-payment remittance advice enhancements

December 2021 Anthem Provider News - Virginia Medicare Dec 1, 2021

Reimbursement policy: Drug screen testing

December 2021 Anthem Provider News - Virginia Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Virginia Medicare Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Provider News - Virginia Medicare Dec 1, 2021

Keep up with Medicare news: December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management
    clinical appropriateness guideline
  • Medical drug benefit Clinical Criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical Policies and Clinical Utilization Management Guidelines update
December 2021 Anthem Provider News - Virginia Medicare Dec 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Virginia Medicaid Nov 1, 2021

Clinical Criteria updates

November 2021 Anthem Provider News - Virginia Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Anthem Provider News - Virginia Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your women patients

November 2021 Anthem Provider News - Virginia Medicaid Nov 1, 2021

Keep up with Medicaid news: November 2021

  • FAQ: New AIM Specialty Health contact center phone number
  • Behavioral therapy assessments
  • Change to DME incontinence benefit limits
  • Prior authorization updates for specialty pharmacy
November 2021 Anthem Provider News - Virginia Medicaid Nov 1, 2021

Medicare Advantage telehealth rural health center and federally qualified health center claims

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

Clinical Criteria updates

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

Anthem Blue Cross and Blue Shield offering Advance Medical Directives program for 2022

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

New York City Medicare Advantage announcement

November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

Keep up with Medicare news: November 2021

  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
November 2021 Anthem Provider News - Virginia Medicare Nov 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

 

New 240k member Group Retiree PPO plan - Virginia Medicare Oct 19, 2021

Diabetes testing and screening HEDIS measures

October 2021 Anthem Provider News - Virginia Medicaid Oct 1, 2021
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