Indiana
Provider Communications

December 2021 Anthem Provider News - Indiana

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Title Category

2022 Medicare Advantage service area and benefit updates

Medicare

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

Medicare

Behavioral healthcare appointment access requirements

Administrative

Case management program

Administrative

Chlamydia is asymptomatic. Only through screening will we know for sure

Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Company to retire Blue Precision program on December 31, 2021

Products & Programs

Coordination of care

Administrative

Good news: Non-payment remittance advice enhancements are here

Medicare

Importance of PCP after-hours messaging

Administrative

Important information about utilization management

Administrative

Is prior authorization required?

Answering your questions about the new Availity Authorization App
Digital Tools

Keep up with Medicaid News - December 2021

  • Outpatient services billed by midlevel providers and advance practice nurses
  • Clinical criteria updates
  • Prior authorization updates for medications billed under the medical benefit
Medicaid

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
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
Medicare

Medical policy and clinical guideline updates - December 2021*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Member rights and responsibilities

Administrative

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*

*Change to Prior Authorization Requirements
Reimbursement Policies

Outpatient system updates for 2022

Administrative

Pharmacy information available at anthem.com

Pharmacy

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Administrative

Professional system updates for 2022

Administrative

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*

*Change to Prior Authorization Requirements
Reimbursement Policies

Reimbursement policy update: Drug screen testing

Medicare

Reimbursement policy update: Virtual Visits - Professional and Facility

Reimbursement Policies

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021
Digital Tools

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

Reimbursement Policies

Somatus is your resource for kidney care management

Medicare

Specialty pharmacy updates - December 2021*

*Change to Prior Authorization Requirements
Pharmacy

Submitting prior authorizations is getting easier

Anthem is transitioning to the Availity Authorization app
Digital Tools

Submitting prior authorizations is getting easier

Medicaid

Submitting prior authorizations is getting easier

Medicare

Unspecified diagnosis reminder

Medicaid

Updated AIM musculoskeletal program site of care reviews delayed

Products & Programs

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medicare

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines
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