ProviderAccess Login
Access our secured site.
Not registered? Register Now


Login
Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan and BlueCard Out-of-Area members.

Enter

Find a Doctor
Search our online provider directory when you need a doctor, hospital or other health care provider.


Network Update

PW_000501

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!

 
Watch for our fall 2016 Provider Seminar Invitation coming soon!
New webinar schedule for ePASS® and SOAP Notes overview; incentives offered
Colorado in-network laboratory update
Anthem implements opioid analgesics utilization management clinical policies
Anthem updates SGLT2 Inhibitor Step Therapy Program
Update to Claims Processing Edits and Professional Reimbursement Policies
Medicare Advantage Updates

Complete your Medicare Advantage AIM OptiNet® registration for X-ray, ultrasound or high-tech imaging services

Please follow CMS guidelines for Medicare Advantage Part B Immunizations Claims Filing

Anthem to conduct periodic audits to ensure CMS requirements are met

Help ensure Medicare Part D members receive a Comprehensive Medication Review

Anthem follows CMS guidelines for DME customization

Keep up with Medicare news

Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)

Preventive care services covered with no member cost-share (updated August 2016)

 
Intranasal flu vaccine will not be covered for upcoming flu season
Updated Escalation Contact List
Updated Alpha Prefix Reference List
Is your Availity Web Portal access up to date?
Use the Interactive Care Reviewer (ICR) to submit and check the precertification status for many of your Anthem patients today!
Anthem implements Pharmacy Home program
Behavioral Health Appointment Access
HEDIS Spotlight: Antibiotic Use
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

Medicare Supplement members to receive new ID cards

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

Alendronate added to the $0 copay tier for 2016 for Medicare Advantage members

Anthem offers in-home Bone Mineral Density (BMD) testing

Program helps members with rheumatoid arthritis that may be missing important medications

Clinical cumulative morphine equivalent dosing point-of-sale edit effective January 1, 2017

Please check your contract prior to rendering supplemental benefits

Complying with Medical Record documentation requests

Medicare notices and provider requirements

Please use Medicare billing guidelines when filing preventive service claims for Anthem Medicare Advantage members

Please follow home health billing instructions

Keep up with Medicare news

Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)

New webinar schedule for ePASS and SOAP Notes overview; incentives offered – July 2016

 
Drug fee schedule update
Reminder: Blue Priority plans expanding to Larimer and Weld counties effective July 1, 2016
Professional Fee Schedule tool now available on Availity Web Portal
Reminder of the most recent updates to the Cancer Care Quality Program
Commercial HEDIS® 2016: Provider incentive winners announced!
Update to Claims Processing Edits and Professional Reimbursement Policies
Medicare Advantage Updates

Reach a nurse directly for prior authorizations that require clinical reviews, services that require Anthem authorization

Additional AIM OptiNet imaging services registration webinars available

Part D drugs must be prescribed for FDA-supported indications, Medicare compendiums

Ensure the accuracy of your information in the provider directory

Claim adjustments may change member cost share

Anthem offers Medicare Advantage member incentive for annual routine physical

Keep up with Medicare news  

Health Care Reform Updates (including Health Insurance Exchange)
 
Blue Priority plans expanded to Larimer and Weld counties effective July 1, 2016
CU Health Plan changes for new open enrollment – effective July 1, 2016
Update: OrthoNet is now accepting PT/OT authorization requests online
Cissy’s Corner – Medical Director, Anthem Blue Cross and Blue Shield
Important Announcement: Risk Adjustment Data Validation Audit
Process update for compound drug claims
Change in breast cancer screening benefit for Federal Employee Program®
HEDIS® Spotlight: Restrict Imaging for Low Back Pain
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

Medicare Advantage AIM OptiNet imaging services initiative postponed

Inpatient stays and observation – please help members maximize health benefits

Prior Authorization Required for Non-Emergency Ambulance Transport to and from Dialysis Treatment

Reminder to bill CLIA Certification for Individual Medicare Advantage

Member cost-share questions? Call number on back of member ID card

Outpatient Part B Nursing and Long-Term-Care Facilities: Contact OrthoNet for OT and PT Prior Authorizations Effective July 1, 2016

Keep up with Medicare news

Health Care Reform Updates (including Health Insurance Marketplace / Affordable Care Act)
 
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