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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!

 
ePASS® webinars on tap to aid in submission of compliant SOAP Notes for targeted Anthem Blue Cross and Blue Shield members; incentives offered
Updated Escalation Contact List
Update to Claims Processing Edits and Professional Reimbursement Policies
Medicare Advantage Updates

Medicare Supplement member ID card change postponed

Imaging scores for outpatient diagnostic imaging could impact reimbursement

HCPCS codes required for RHC claims

Precertification requirements updated for 2016

Keep up with Medicare news

Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)
 
Drug fee schedule update
Spring Provider Seminars: Special Topic – Commercial Risk Adjustment for ACA members – Registration ends Monday, April 4th at 4pm!
Anthem Whole Health ConnectionSM
Cissy’s Corner – Medical Director, Anthem Blue Cross and Blue Shield
Reminder: Behavioral Health educational outreach
Required Behavioral Health Follow-ups
New Residential Treatment Center benefit for FEP®
New: Find valuable Anthem information under Payer Spaces on the Availity Web Portal
Process update for Compound Drug claims
HEDIS® 2016: Comprehensive Diabetes Care – Eye Exam
Precision Medicine: Cancer Care Quality Program expansion supports NCI-MATCH
Reminder of the most recent updates to the Cancer Care Quality Program
Update on precertification of cardiovascular services
Updates to Blue Physician Recognition Program
Important reminders about providing services to out-of-state BCBS Medicaid members
DHS shares information on opioid abuse
Update to Claims Processing Edits and Professional Reimbursement Policies
Medicare Advantage Updates

AIM to conduct medical necessity reviews for radiology, cardiology, sleep services

Additional radiation oncology prior authorizations should be directed to AIM effective July 1, 2016

AIM to review oncology and oncology supportive specialty drugs for medical necessity

Dual Eligible Special Needs Plans training required

Quality programs support patient safety, health improvement

Keep up with Medicare Advantage news

Health Care Reform Updates and notifications
 
After Hours Reminder
Lower cost Emergency Room alternatives for members
Have a question about a claim? Check out the Secure Messaging via the Availity Web Portal
ConditionCare Program Benefits Members and Physicians
Integrated Care Model for plans purchased on Connect for Health Colorado benefits members and physicians
Update to Claims Processing Edits and Professional Reimbursement Policies
Medicare Advantage Updates

Keep up with Medicare Advantage news

Health Care Reform Updates and notifications
 
Guidelines when a member can see another PCP if a different than the PCP is listed on the Member’s ID card
Anthem and the QuitLine Partnering to Strengthen Tobacco Cessation Program
Updated Escalation Contact List
New precertification requirements for certain cardiovascular services begins March 1, 2016
New precertification requirements for certain radiation therapy services begins March 1, 2016
Secure Web portal user profiles and HIPAA compliance reminder
Improving documentation of high blood pressure
Important information about providing services to out-of-state Medicaid members
Diabetes Prevention Program managed by Solera Health (formerly Viridian Health Management)
Anthem to Discontinue Delivery of Multiple F Checks in the HIPAA 835 Payment Cycle
Update to Claims Processing Edits and Professional Reimbursement Policies
Commercial HEDIS® 2016 starts early February
Clinical Practice and Preventive Health Guidelines available online
Pharmacy information available on anthem.com
Medicare Advantage Updates

Anthem encourages care coordination for Medicare Advantage members with depression

Additional support available for individual Medicare Advantage members with rare conditions

HIPPS codes required for SNF and HHA claims

Provider Requirements and Medicare Notices

Help ensure Anthem members have accurate information about your practice

Please review formulary changes to help members find best medication values

Keep up with Medicare Advantage news

Health Care Reform Updates and notifications

Incentive opportunity for physicians treating patients with Anthem’s Affordable Care Act (ACA) compliant plans purchased on or off the exchange

 
Drug fee schedule update
2016 FEP Benefit information available online
Medical Record Processing Changes for 2016
Introducing 2016 Anthem’s Quality-In-Sights® Primary Care Incentive Program for Primary Care Providers
Proactively prevent diabetes among your patients
Updated Alpha Prefix Reference
Updated Escalation Contact List
CVS/Specialty provides in-network specialty pharmacy
Anthem Care Comparison gives Anthem members and providers the complete picture of costs associated with medical procedures
AIM Specialty Health® online Pre-authorization Requests (for Ordering and Servicing Providers) can be accessed via the Availity Web Portal
Facility Audit Vendor Partner Name Change
Update to Claims Processing Edits and Professional Reimbursement Policies
Clinical Practice and Preventive Health Guidelines available online
Pharmacy information available on anthem.com
Medicare Advantage Updates

Help ensure Anthem members have accurate information about your practice

Please review formulary changes to help members find best medication values

Health Care Reform Updates and notifications

Member ID card summary for ACA-compliant health plans

 
 
 
©2005-2016 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