Virginia
Provider Communications

Articles Month: March 2023

Title Publication Category Date

Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional

April 2023 Provider News - Virginia Reimbursement Policies Mar 31, 2023

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

April 2023 Provider News - Virginia Administrative Mar 31, 2023

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

April 2023 Provider News - Virginia Administrative Mar 31, 2023

CAA: Maintain your online provider directory information

April 2023 Provider News - Virginia Administrative Mar 31, 2023

Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)

April 2023 Provider News - Virginia Administrative Mar 31, 2023

Helping to reduce delays when submitting attachments

April 2023 Provider News - Virginia Administrative Mar 31, 2023

Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023

April 2023 Provider News - Virginia Administrative Mar 31, 2023

Medical Oncology Program ProviderPortal case entry enhancements

April 2023 Provider News - Virginia Administrative Mar 31, 2023

New guideline for electronic medical record; clinical data sharing; and admission, discharge, and transfer notifications

April 2023 Provider News - Virginia Administrative Mar 31, 2023

Durable medical equipment Availity Essentials instructions

April 2023 Provider News - Virginia Digital Tools Mar 31, 2023

Provider Pathways - Doing Business with Anthem HealthKeepers Plus eLearning is here!

April 2023 Provider News - Virginia Digital Tools Mar 31, 2023

Survey for all skilled nursing facilities

April 2023 Provider News - Virginia Digital Tools Mar 31, 2023

Genetic Testing claim edits

April 2023 Provider News - Virginia Coverage and Clinical Guidelines Mar 31, 2023

Bundled Services and Supplies - Professional

April 2023 Provider News - Virginia Reimbursement Policies Mar 31, 2023

Pay Doctor Bill (provider payment option) - General FAQ

April 2023 Provider News - Virginia Products & Programs Mar 31, 2023

Let’s Vaccinate

April 2023 Provider News - Virginia Products & Programs Mar 31, 2023

Pharmacy information available on our provider website

April 2023 Provider News - Virginia Pharmacy Mar 31, 2023

HEDIS 2023 Federal Employee Program medical record request requirements

April 2023 Provider News - Virginia Federal Employee Plan (FEP) Mar 31, 2023

FEP Quality Reimbursement Program update

April 2023 Provider News - Virginia Federal Employee Plan (FEP) Mar 31, 2023

Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare Advantage

April 2023 Provider News - Virginia Medicare Mar 31, 2023

E-visits

April 2023 Provider News - Virginia Medicare Mar 31, 2023

Ready, set, renew!

April 2023 Provider News - Virginia Medicaid Mar 31, 2023

Correct coding for hospital outpatient clinic visits for Medicaid

April 2023 Provider News - Virginia Medicaid Mar 31, 2023

Family planning and long-acting reversible contraception

April 2023 Provider News - Virginia Medicaid Mar 31, 2023

Keep up with Medicaid news - March 2023

  • Clinical Criteria updates
  • Prior authorization requirement changes
  • Provider orientation and training
  • Change to vaccine age limitations
April 2023 Provider News - Virginia Medicaid Mar 31, 2023

Keep up with Medicare news - April 2023

  • Clinical Criteria updates
  • Clinical Criteria updates
  • Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • Blue Cross and Blue Shield expands specialty pharmacy precertification list
  • New specialty pharmacy medical step therapy requirements
  • Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)
April 2023 Provider News - Virginia Medicare Mar 31, 2023

Reminder: Updated Carelon Medical Benefits Management, Inc. Musculoskeletal Program effective April 1, 2023 - Site of care reviews

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Outpatient Facility Revenue Code Billing Requirements - Facility

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Advancing Mental Health Equity for Youth & Young Adults

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Provider directory - annual audit for NCQA Accreditation

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Time to prepare for HEDIS medical record review

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Upcoming amendment changes for Commercial reimbursement policies for Virginia

March 2023 Anthem Provider News - Virginia Reimbursement Policies Mar 1, 2023

Clinical Criteria updates for specialty pharmacy are available

March 2023 Anthem Provider News - Virginia Pharmacy Mar 1, 2023

Specialty pharmacy updates for March 2023

March 2023 Anthem Provider News - Virginia Pharmacy Mar 1, 2023

Policy Update: Modifiers 25 and 57 (Policy G-06003, effective 04/01/2023)

March 2023 Anthem Provider News - Virginia Medicaid Mar 1, 2023

Keep up with Medicaid news - March 2023

  • Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
  • Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List
  • Carelon Medical Benefits Management, Inc. Radiology Clinical Appropriateness Guidelines CPT code list update
  • Clinical Criteria updates
  • Prior authorization updates for medications billed under the medical benefit (Carvykti)
  • Prior authorization updates for medications billed under the medical benefit (Aduhelm)
  • Applied behavior analysis
March 2023 Anthem Provider News - Virginia Medicaid Mar 1, 2023

Keep up with Medicare news - March 2023

  • Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List in Virginia
  • Carelon Medical Benefits Management, Inc.Genetic Testing Clinical Appropriateness Guidelines CPT code list update
  • What date to select for inpatient admissions for claims
  • Clinical Criteria updates
  • New specialty pharmacy medical step therapy requirements
  • Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
March 2023 Anthem Provider News - Virginia Medicare Mar 1, 2023

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

March is National Colorectal Cancer Awareness Month

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Reminder - Updated Carelon Musculoskeletal Program effective April 1, 2023: monitored anesthesia care reviews

March 2023 Anthem Provider News - Virginia Administrative Mar 1, 2023

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

March 2023 Anthem Provider News - Virginia Products & Programs Mar 1, 2023

Pharmacy information available on our provider website

March 2023 Anthem Provider News - Virginia Pharmacy Mar 1, 2023

Annual planned visits

March 2023 Anthem Provider News - Virginia Medicare Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Anthem Provider News - Virginia Medicare Mar 1, 2023

Shared savings and transition care management after inpatient discharges

March 2023 Anthem Provider News - Virginia Medicare Mar 1, 2023

Informational Update Modifier Usage

March 2023 Anthem Provider News - Virginia Medicare Mar 1, 2023
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