Tagged with Anthem
Beginning with claims processed on and after April 26, 2020, Anthem Connecticut will be enhancing its outpatient facility edits for revenue codes, Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System (HCPCS) and modifiers.
Anthem is introducing a new program to reduce the administrative burden associated with current prior authorization (PA) processes for providers who are contracted with Anthem in Connecticut. The Prior Auth Pass Program allows providers who meet program requirements to waive prior authorization for select outpatient medical procedures that generally have high rates of PA requests and approvals.
Anthem Blue Cross Blue Shield (Anthem) continues to streamline its medical specialty drug reviews by transitioning another drug review process from AIM to Anthem’s medical specialty drug review team. Beginning June 15, for all requests, regardless of service date, providers will need to submit a new prior authorization request by contacting Anthem’s medical specialty drug review team.
Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1.
Anthem has released an update regarding the coding of bundled services for continuous intraoperative neurophysiology monitoring, from outside the operating room.
Anthem has posted several reimbursement policy updates, including updates to its Rule of Eight” Reporting Guidelines, system updates for 2019, and updates to policy for Modifier 69.
Anthem Wisconsin has updated certain medical policies and clinical utilization management (UM) guidelines to support clinical coding edits.
Anthem is updating its editing systems to automate edits supported by correct coding guidelines, as documented in industry sources such as CPT®, HCPCS Level II, and ICD-10. Anthem states the enhanced editing automation will promote faster claim processing and reduce follow-up audits and/or record requests for claims not consistent with correct coding guidelines.
Anthem Blue Cross Blue Shield (BCBS) posted professional reimbursement updates for its policy for once per lifetime procedures bundled and services and supplies.
Anthem BCBS Connecticut has updated several of its reimbursement policies, including OBGYN policies, and language changes to professional reimbursement policies.
Following a review of its current medical polices, Anthem BlueCross BlueShield (BCBS) has released an updated list of medical policies which will be converted to clinical guidelines, effective May 1.
Effective May 1, Anthem Blue Cross and Blue Shield in Virginia (BCBS VA) will implement new and revised coverage guidelines approved at the most recent quarterly Medical Policy and Technology Assessment Committee meeting.
Anthem Blue Cross and Blue Shield (BCBS) has published a notice informing health care professionals and policyholders that the insurer will no longer proceed with the reimbursement policy impacting physician use of payment Modifier 25.
As of January 1st, Anthem expanded its BadgerCare Plus and Medicaid Supplemental Security Income (SSI) plans to seven counties in Wisconsin.
As of January 1st, Ohio Senate Bill 129 (House Bill 505) now requires insurers to implement faster turn-around times for reviews of prior-authorizations (PA) that are submitted electronically.
Anthem BCBS of Indiana has issued notice of medical policy revisions approved by the Medical Policy and Technology Assessment Committee (MPTAC).
Effective March 1, 2018, AIM Specialty Health (AIM) will perform medical necessity review of certain elective surgeries of the spine and joints, as well as interventional pain treatment for fully insured Anthem BSBS NH members.
Starting in 2018, more claim payments and remittance advice issued to Anthem providers will be made on a weekly basis.
Effective December 8, Anthem EDI began implementation of a new edit related to independent laboratory claims which reduces the processing time and manual intervention for lab claims.
For dates of service on or after December 1, 2017, Anthem Blue Cross and Blue Shield (Anthem BCBS) will begin reimbursement for Psychiatric Care Collaborative Management Healthcare Common Procedure Coding System (HCPCS Level II) codes.