Tagged with BCBS Blue Cross Blue Shield

Anthem Medical Non-Oncology Specialty Drug Review Changes

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 Announces Fee Schedule Changes

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 – Enhanced Automated Claim 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.

BCBS Vermont New, Revised and Deleted Codes Released

Following Blue Cross and Blue Shield of Vermont’s (BCBSVT) review of the CPT® and HCPCS additions, deletions and revisions for October 1, the insurer has made several changes involving prior approval, investigational services, and unit designation.

New Hampshire Anthem BSBS New Musculoskeletal Program

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.

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