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Network Update

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Network Update is an Anthem Blue Cross and Blue Shield newsletter sent to our Colorado network providers each month. Start receiving Network Update and all Anthem network communications via email, click Anthem Network eUpdate Registration Form to sign up TODAY!

Fall Provider Seminars coming soon!
Reminder: Alpha prefix VAD is tied to our PPO network; it is not affiliated with the Pathway network
‘NEW’ ProviderAccess Account Administrator Change Form
Incorrect Alpha Prefix on GameStop ID Cards
Attention Oncologists and Hematologists: Cancer Care Quality Program Begins November 1, 2014
Non-participating lab referrals
Update to Claims Processing Edits and Professional Reimbursement Policies
Clinical Practice and Preventive Health Guidelines Available on the Web
Pharmacy information available on anthem.com
Medicare Advantage Updates

Medicare Advantage Specialty Pharmacy Team requires pre-certification of certain drugs within the WellPoint Cancer Care Quality

Select cardiac services to be reviewed

Health Care Reform Updates (including Health Insurance Exchange)
 
AIM Specialty Health update for the Federal Employee Program®
2014 Medical chart review for members who have purchased plans on or off the Exchange – Began in July
Inovalon continues outreach efforts on Anthem’s behalf to help identify members needing care
Updated Alpha Prefix Reference
Updated Escalation Contact List
Credentialing process and managing provider updates: Helpful Tips
Interactive Care Reviewer (ICR) – Updates
Update to Claims Processing Edits and Professional Reimbursement Policies
HEDIS® 2014: Provider incentive winners announced!
Cultural competence provider trainings available (with CME credits provided)
Medicare Advantage Updates

Free support for Medicare Advantage Members with Type 2 Diabetes

ICD-10: Another delay provides another opportunity

Avoid second fills of High-Risk Medications

Improve Medicare Advantage members’ medication adherence with 90-day prescriptions

Anthem to fax ADA guideline reminders, coordinate office visits for members with diabetes

Health Care Reform Updates (including Health Insurance Exchange)
 
Drug fee schedule update
Spring 2014 Provider Webinars – recorded versions now available online
Anthem and the QuitLine Partnering to Strengthen Tobacco Cessation Program
Behavioral Health Audits
Upcoming Accessibility Survey for Behavioral Health Providers
CoramRx/CVS Caremark Change for Specialty Drugs Covered Under the Medical Benefit
Update to Claims Processing Edits and Professional Reimbursement Policies
Case Management Program
Clinical Practice and Preventive Health Guidelines Available on the Web
Important Information about Utilization Management
Pharmacy information available on anthem.com
Members’ Rights and Responsibilities
Medicare Advantage Updates

Anthem Coordinates Office Visits for Preventive Screenings

Tips for improving HEDIS Documentation on Asthma

Measure members’ body mass index regularly

Reminder: Please Precertify Cardiac Catheterizations

Update: Routine Physical Exams Are Covered in 2014

Health Care Reform Updates (including Health Insurance Exchange)
 
Updated Alpha Prefix Reference List for Health Insurance Exchange information
CU Health Plan changes for new open enrollment – effective July 1, 2014 [CO ONLY]
Need to check the status of an authorization? Don’t call! Use Interactive Care Reviewer
The final Mental Health Parity Rule released
PAP Device data required for ongoing Sleep Therapy Treatment requests
AIM Specialty Health expanded to the Federal Employee Program®
Infusion therapy choice: lower out-of-pocket expenses and convenience for members
Update to Claims Processing Edits and Professional Reimbursement Policies
Health Care Reform Updates (including Health Insurance Exchange)

New Health Insurance Exchange article available online: Verify member grace period status electronically using Availity or EDI – May 2014

 
Drug fee schedule update
Spring Provider Seminars Happening now!
Update to Claims Processing Edits and Professional Reimbursement Policies
Service Diagnosis Positioning
We Believe in Continuous Improvement
Clinical Practice and Preventive Health Guidelines Available on the Web
Coordination of Care
Pharmacy information available on anthem.com
Condition Care Program Benefits Patients and Physicians
Medicare Advantage Updates

House Call Program Helps Coordinate Care for Medicare Advantage Members

Medicare Advantage Members to Receive Monthly Summary Statements

2014 Medical Chart Review Program for Medicare Advantage Members under way

Anthem Helps Members Schedule Office Visits, Preventive Screenings

HEDIS Measures Help Promote Quality Health Care

Anthem Works to Prevent Opioid Overutilization among Medicare Advantage Members

Health Care Reform Updates (including Health Insurance Exchange)
 
Spring Provider Seminars coming soon!
Statement regarding delay of ICD-10 compliance date
Post ProviderAccess Shut down of functionality FAQs and reminders of Availity and ProviderAccess changes
New Electronic Provider Access (EPA) Feature Available
UPDATE: Anthem works with Inovalon to conduct health assessments for members enrolled in health plans purchased on and off the Exchange
Update to Claims Processing Edits and Professional Reimbursement Policies
Anthem provides guidance for overpayments and recoveries reported on the HIPAA 835 electronic remittance advice
Facilities Must Ensure All UB04 Fields Are Correct
Medicare Advantage Updates

Medicare Advantage Members Receive Personalized Checklist for Preventive Services

Speaking the Language of ICD-10 - Part 4

Billing for Medicare Primary Members – Correct Use of the GY Modifier

Anthem moves from 17th to 18th Edition of MCG™ Guidelines effective April 28, 2014

Health Care Reform Updates and notifications
 
ProviderAccess Shutdown IMPORTANT: Time is Running Out – Register for Availity
Important information about new paper claim requirements
Interactive Care Reviewer now offers inquiry capability and accepts inpatient requests
AIM Clinical Appropriateness Guideline Updates
Update to Claims Processing Edits and Professional Reimbursement Policies
ICD-10: It’s Time to Test with Anthem
Cost Transparency Expands
Referenced Based Benefits
Reminder for Voluntary Refunds
Enhanced Patient Rating and Review Tool
HEDIS®: The Childhood and Adolescent Measures
Clinical Practice and Preventive Health Guidelines available on the web!
Pharmacy information available on anthem.com
Medicare Advantage Updates

2014 House Call Program available at no out-of-pocket cost to Medicare Advantage Members

CMS Introduces New Patient Management Quality Measures

CMS Monitors Medicare Part D Patient Safety

Anthem moves from 17th to 18th Edition of MCG™ Guidelines effective April 28, 2014

Health Care Reform Updates (including Health Insurance Exchange)
 
Please work with your ProviderAccess Users to get them transitioned to the Availity Web Portal
Availity upcoming workshops in Colorado
User Profiles and HIPAA compliance reminder
Update to Claims Processing Edits and Professional Reimbursement Policies
MyHealth Advantage works with you to help your patients
Medicare Advantage Updates

Anthem encourages Medicare Advantage members to stay up-to-date on preventive care

Annual surveys ask members to rate their quality of care and their Medicare Advantage health plan

Adult BMI and HEDIS - please record exact number, not range

Update: Medicare Advantage Specialty Pharmacy Unit phone option

BCBSA Initiative Helps Insure Timely and Accurate Payment for Secondary Payer Medicare Claims - REMINDER of Duplicate Claims Handling for Medicare Crossover

Health Care Reform Updates (including Health Insurance Exchange)
 
Drug fee schedule update
Updated CMS 1500 claim form version 02/12 to be accepted beginning January 6, 2014
Member eligibility, benefits and claims status inquiry functions moving exclusively to the Availity Web Portal from ProviderAccess
ICD-10: It’s Time to Test with Anthem
Reminder: Surveys for the 2013 Anthem Quality-In-Sights® Primary Care Incentive Program due no later than February 28, 2014
Update to Claims Processing Edits and Professional Reimbursement Policies
Reminder: new additional Applied Behavioral Analyst HCPCS codes effective January 1, 2014
HEDIS® 2014: it’s time to show our quality!
Clinical Practice and Preventive Health Guidelines available on the web!
Pharmacy information available on anthem.com
Future Moms promotes healthy pregnancies and healthy babies
Medicare Advantage Updates

CPT II codes can help reduce administrative burden

Speaking the language of ICD-10 - Part 3

2014 House Call Program Available at No Out-of-Pocket Cost to Medicare Advantage Members

Health Care Reform Updates (including Health Insurance Exchange)

Provider Checklist: The Health Insurance Marketplace is here. Are you ready?

 
 
©2005-2014 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use