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Site of Care* medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021

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Digital Tools Test 2 - Word Count Limit is 65 - Digital Tools - CA Products & Programs May 18, 2021

Request referrals for Empire Individual Network Plan through Interactive Care Reviewer

Digital Tools Test 2 - Word Count Limit is 65 - Digital Tools - CA Administrative May 18, 2021

Clinical Criteria updates for specialty pharmacy are available

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Digital Tools Test 2 - Word Count Limit is 65 - Digital Tools - CA Medical Policy & Clinical Guidelines May 18, 2021

Test Digital Tools

Digital Tools Test 2 - Word Count Limit is 65 - Digital Tools - CA Digital Tools May 18, 2021

Check Hyperlink Issue - Site of Care* medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021 (MAC) - Excerpt

Empire BlueCross BlueShield (“Empire”) is committed to being a valued health care partner in identifying ways to achieve better health outcomes, lower costs and deliver access to a better healthcare experience for consumers.

Members enrolled in Empire commercial plans will require a medical necessity review of the site of care for numerous surgical procedures performed in an outpatient hospital setting with dates of service on or after January 1, 2021. Clinical guideline CG-SURG-52, Site of Care: Hospital-Based Ambulatory Surgical Procedures and Endoscopic Services will apply to the review process. AIM Specialty Health® (AIM) will administer the review.

When conducting an eligibility and benefits inquiry for Anthem members, simply select View Member ID Card on the Eligibility and Benefits results page. Note: the Availity portal requires you to enter the member’s ID number as well as a date of birth or the member’s first and last name into the search options in order to submit an E&B inquiry.

When conducting an eligibility and benefits inquiry for Anthem members, simply select View Member ID Card on the Eligibility and Benefits results page. Note: the Availity portal requires you to enter the member’s ID number as well as a date of birth or the member’s first and last name into the search options in order to submit an E&B inquiry.

Provider News

When conducting an eligibility and benefits inquiry for Anthem members, simply select View Member ID Card on the Eligibility and Benefits results page. Note: the Availity portal requires you to enter the member’s ID number as well as a date of birth or the member’s first and last name into the search options in order to submit an E&B inquiry.

N/A Administrative Dec 4, 2020

Issue - Site of Care* medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021 (MAC) - Excerpt

Empire BlueCross BlueShield (“Empire”)© is committed to being a valued health care partner in identifying ways to achieve better health outcomes, lower costs and deliver access to a better healthcare experience for consumers.

Members enrolled in Empire commercial plans will require a medical necessity review of the site of care for numerous surgical procedures performed in an outpatient hospital setting with dates of service on or after January 1, 2021. Clinical guideline CG-SURG-52, Site of Care: Hospital-Based Ambulatory Surgical Procedures and Endoscopic Services will apply to the review process. AIM Specialty Health® (AIM) will administer the review.
Test Oct Publication - SB Products & Programs Nov 17, 2020

Empire updates formulary lists for commercial health plan pharmacy benefit (Featured Article)

Test Oct Publication - SB Pharmacy Nov 17, 2020

Designated Specialty Pharmacies in 2021

Test Oct Publication - SB Pharmacy Nov 17, 2020

National Drug Code requirement on outpatient claims (MAC)

Test Oct Publication - SB Pharmacy Nov 17, 2020

Prior authorization updates for specialty pharmacy are available

Test Oct Publication - SB Pharmacy Nov 17, 2020

Updated Coverage for Breast Cancer prevention medications

Test Oct Publication - SB Pharmacy Nov 17, 2020

FDA approvals and expedited pathways used - New Molecular Entities (NMEs)

Test Oct Publication - SB Pharmacy Nov 17, 2020

Pharmacy information available on empireblue.com

Test Oct Publication - SB Pharmacy Nov 17, 2020

Keep up with important news from Empire and receive notifications by email (FEATURED/SPOTLIGHT)

Test Oct Publication - SB Administrative Nov 17, 2020

New Digital Provider Enrollment tool added to Availity for New York

Test Oct Publication - SB Administrative Nov 17, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

Test Oct Publication - SB Administrative Nov 17, 2020

Charges for Personal Protective Equipment by Participating Providers

Test Oct Publication - SB Administrative Nov 17, 2020

Electronic member ID cards available on the Availity Portal

Test Oct Publication - SB Administrative Nov 17, 2020

Empire Chat: A fast, easy way to have your questions answered

Test Oct Publication - SB Administrative Nov 17, 2020

Interactive Care Reviewer adds outpatient medical authorization requests for Empire local, State and City plans

Test Oct Publication - SB Administrative Nov 17, 2020

Request referrals for Empire Individual Network Plan through Interactive Care Reviewer

Test Oct Publication - SB Administrative Nov 17, 2020

New Medical Claim Attachment Webinars: Register Today

Test Oct Publication - SB Administrative Nov 17, 2020

National Accounts 2021 Pre-certification list

Test Oct Publication - SB Administrative Nov 17, 2020

CRA Reporting Update: New guidance on telephone-only service CPT codes for Risk Adjustment Program

Test Oct Publication - SB Administrative Nov 17, 2020

What Matters Most: Improving the Patient Experience

Test Oct Publication - SB Administrative Nov 17, 2020

Issue - Medical Policy Updates (MAC) - bullets

Test Oct Publication - SB Medical Policy & Clinical Guidelines Nov 17, 2020

Clinical Criteria updates for specialty pharmacy are available (MAC)

Test Oct Publication - SB Medical Policy & Clinical Guidelines Nov 17, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

Test Oct Publication - SB Medical Policy & Clinical Guidelines Nov 17, 2020

REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020

Test Oct Publication - SB Medical Policy & Clinical Guidelines Nov 17, 2020

Reimbursement Policy Update: Emergency Department: Leveling of Evaluation and Management Services (Facility) (MAC)

Test Oct Publication - SB Reimbursement Policies Nov 17, 2020

Reimbursement policy update: Laboratory and Venipuncture (Professional) (MAC)

Test Oct Publication - SB Reimbursement Policies Nov 17, 2020

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List (MAC)

Test Oct Publication - SB Federal Employee Plan (FEP) Nov 17, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

Test Oct Publication - SB Medicare Nov 17, 2020

SOMOS to manage delegated functions effective October 1, 2020

Test Oct Publication - SB Medicare Nov 17, 2020

Prior authorization requirements for E0482

Test Oct Publication - SB Medicare Nov 17, 2020

Asthma controller medications

Test Oct Publication - SB Medicare Nov 17, 2020

Patient360 enhancement for medical providers

Test Oct Publication - SB Medicare Nov 17, 2020

Issue - Coding spotlight: providers guide to coding for behavioral health disorders Behavioral health disorders are classified in Chapter 5 of the ICD-10-CM

Test Oct Publication - SB Medicare Nov 17, 2020

Keep up with Medicaid news

Test Oct Publication - SB Medicare Nov 17, 2020

Prior authorization requirements for the below codes (December 1, 2020)

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Prior authorization requirements for the below codes (January 1, 2021)

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Patient360 enhancement for medical providers

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Social determinants of health support expanding with GroundGame Health

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Evaluation and management services correct coding

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Provider transparency update

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Medical drug benefit Clinical Criteria updates

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Keep up with Medicare news

Test Oct Publication - SB Medi-Cal Managed Care Nov 17, 2020

Prior authorization requirements for the below codes (January 1, 2021) - Clone

Test Oct Publication - SB Policy Updates Nov 17, 2020

Issue - Table Test

Test Oct Publication - SB Medical Policy & Clinical Guidelines Nov 17, 2020

Testing Bullets

N/A Administrative Oct 21, 2020

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N/A Pharmacy Oct 16, 2020

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QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Medicare Oct 14, 2020

QA Table Test - 0901.2 (Keep up with Medicare news) (Keep up with Medicare news) (Keep up with Medicare news) (Keep up with Medicare news) (Keep up with Medicare news)

 
 
 
 
 
 
 
 
 
 
QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Medicare Oct 9, 2020

QA-1-Test (Keep up with Medicare news)

 
 
 
 
 
 
 
 
 
 
 
 
QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Medicare Oct 8, 2020

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QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Guideline Updates Oct 8, 2020

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QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Administrative Oct 8, 2020

Top-Testing New Article

 
 
 
 
QA Testing Publication Register now to learn about COVID-19 relief for providers – Webinar this Thursday Administrative Oct 8, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated May 11, 2020) 2

For the latest COVID-19 information, please check Provider News often.
N/A Policy Updates May 18, 2020

Anthem to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19 5

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. This Thursday, April 30, 2020, Anthem is hosting a webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.

The federal Coronavirus, Aid, Relief and Economic Security (CARES) Act included an initial $350 billion Paycheck Protection Program that provides 100% federally guaranteed loans to small employers. On Monday, April 27, 2020, the SBA resumed accepting applications for PPP loans in response to an additional $320 billion added to the program in recent days. These loans may be forgiven if borrowers maintain or restore their payrolls to pre-COVID-19 levels.

Register now to learn more about federal financial relief for providers in response to COVID-19 (space is limited). A webinar recording will be available on our Provider News page on Anthem.com.

Webinar date and time
Thursday, April 30, 2020
5 p.m. to 6 p.m. EDT

Select “Learn more” for details and to register now.
N/A Products & Programs May 18, 2020

Anthem to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19 1

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. This Thursday, April 30, 2020, Anthem is hosting a webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.  

The federal Coronavirus, Aid, Relief and Economic Security (CARES) Act included an initial $350 billion Paycheck Protection Program that provides 100% federally guaranteed loans to small employers. On Monday, April 27, 2020, the SBA resumed accepting applications for PPP loans in response to an additional $320 billion added to the program in recent days. These loans may be forgiven if borrowers maintain or restore their payrolls to pre-COVID-19 levels.  

Register now to learn more about federal financial relief for providers in response to COVID-19 (space is limited). A webinar recording will be available on our Provider News page on Anthem.com.  

Webinar date and time
Thursday, April 30, 2020
5 p.m. to 6 p.m. EDT

REGISTER NOW to learn more about federal financial relief for providers in response to COVID-19.

Select “Learn more” for details and to register now.
N/A Administrative May 18, 2020

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Updated COVID-19 Medicare Information - TEST Disappearing states - CA Administrative May 12, 2020

Telehealth Billing

N/A Administrative May 4, 2020

Information from [BRAND] for Care Providers about COVID-19 (Updated [Current date])

N/A Administrative May 4, 2020

Anthem Blue Cross to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. As previously communicated,  Anthem is hosting a webinar today to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.  

The federal Coronavirus, Aid, Relief and Economic Security (CARES) Act included an initial $350 billion Paycheck Protection Program that provides 100% federally guaranteed loans to small employers. On Monday, April 27, 2020, the SBA resumed accepting applications for PPP loans in response to an additional $320 billion added to the program in recent days. These loans may be forgiven if borrowers maintain or restore their payrolls to pre-COVID-19 levels.  

Register now to learn more about federal financial relief for providers in response to COVID-19 (space is limited). A webinar recording will be available on our Provider News page on Anthem.com.  

Webinar date and time
Thursday, April 30, 2020
5 p.m. to 6 p.m. EDT  

Select “Learn more” for details and to register now.
N/A Administrative Apr 30, 2020

Anthem Blue Cross to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. As previously communicated,  Anthem is hosting a webinar today to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.
N/A Administrative Apr 30, 2020

Anthem to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19.

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. On Thursday, April 30, 2020, Anthem is hosting a webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers. REGISTER NOW to learn more about federal financial relief for providers in response to COVID-19.
COVID-19 Information Administrative Apr 28, 2020

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If you have questions that you would like to submit in advance, please submit them by April 29 at 5 p.m. EDT.

N/A Administrative Apr 28, 2020

Anthem to host webinar for network providers on SBA loans and other federal relief programs in response to COVID-19

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. This Thursday, April 30, 2020, Anthem is hosting a webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.  

The federal Coronavirus, Aid, Relief and Economic Security (CARES) Act included an initial $350 billion Paycheck Protection Program that provides 100% federally guaranteed loans to small employers. On Monday, April 27, 2020, the SBA resumed accepting applications for PPP loans in response to an additional $320 billion added to the program in recent days. These loans may be forgiven if borrowers maintain or restore their payrolls to pre-COVID-19 levels.  

Register now to learn more about federal financial relief for providers in response to COVID-19 (space is limited). A webinar recording will be available on our Provider News page on Anthem.com.  

Webinar date and time
Thursday, April 30, 2020
5 p.m. to 6 p.m. EDT

Select “Learn more” for details and to register now.
COVID-19 News from Anthem Blue Cross - April 28, 2020 (California) Administrative Apr 28, 2020

4.24 Table Test

N/A Administrative Apr 24, 2020

4.24 Bullet Test 2

N/A Administrative Apr 24, 2020

4.24 Font Test

We recently updated FAQs about coding for telephonic-only visits, and Anthem’s affiliated health plan’s membership.

N/A Administrative Apr 24, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) audit happening now

N/A Products & Programs Apr 24, 2020

Access requirements for behavioral health care services

N/A Behavioral Health Apr 24, 2020

Clinical Criteria and prior authorization updates for specialty pharmacy are available

N/A Pharmacy Apr 24, 2020

Pharmacy information available on anthem.com

N/A Pharmacy Apr 24, 2020

An update about Anthem’s direct contracting effort for NPs and PAs

N/A Administrative Apr 24, 2020

Commercial fee schedule update from Anthem Blue Cross and Blue Shield in Virginia

N/A Administrative Apr 24, 2020

Anthem launches Sydney on September 1; New app offers better digital health care support to members

N/A Administrative Apr 24, 2020

PCP after-hours access requirements

N/A Administrative Apr 24, 2020

Misrouted protected health information (PHI)

N/A Administrative Apr 24, 2020

Register today for Anthem’s fall webinar scheduled for October 10

N/A Administrative Apr 24, 2020

Receive important email notifications

N/A Administrative Apr 24, 2020

Claim editing update for Excludes1 notes

N/A Reimbursement Policies Apr 24, 2020

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019

N/A Medical Policy & Clinical Guidelines Apr 24, 2020

Clinical practice and preventive health guidelines available on the Web

N/A Guideline Updates Apr 24, 2020

Prior authorization changes

N/A Medical Policy & Clinical Guidelines Apr 24, 2020

Coming soon: Electronic attachments

N/A Medicare Apr 24, 2020

Clinical Criteria updates

N/A Medicare Apr 24, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

N/A Medicare Apr 24, 2020

Changes to PA requirements

N/A Medicare Apr 24, 2020

Pharmacy benefit manager change to IngenioRx

N/A Medicare Apr 24, 2020

Keep up with Medicare news

N/A Medicare Apr 24, 2020

4.24 Bullet Test

N/A Administrative Apr 24, 2020

4.24 Excerpt Test

We recently updated FAQs about coding for telephonic-only visits, and Anthem’s affiliated health plan’s membership.

N/A Administrative Apr 24, 2020

Keep up with Medicare news

April 2020 Anthem Provider News Medicare Apr 23, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) audit happening now

April 2020 Anthem Provider News Products & Programs Apr 23, 2020

Access requirements for behavioral health care services

April 2020 Anthem Provider News Behavioral Health Apr 23, 2020

Clinical Criteria and prior authorization updates for specialty pharmacy are available

April 2020 Anthem Provider News Pharmacy Apr 23, 2020

Pharmacy information available on anthem.com

April 2020 Anthem Provider News Pharmacy Apr 23, 2020

An update about Anthem’s direct contracting effort for NPs and PAs

April 2020 Anthem Provider News Administrative Apr 23, 2020
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