Nevada
Provider Communications

Articles Month: December 2018

Title Publication Category Date

Provider and Facility Manual update effective February 1, 2019 - NV

Provider and Facility Manual update effective February 1, 2019 - NV Administrative Dec 28, 2018

New Autism Codes Effective January 1, 2019 - NV

New Autism Codes Effective January 1, 2019 - NV Administrative Dec 12, 2018

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

December 2018 Anthem Important Updates - NV Reimbursement Policies Dec 1, 2018

Affordable Care Act Plans offered in 2019

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Networks at a Glance

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Updated Escalation Contact List

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

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

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Update to AIM Clinical Appropriateness Guidelines

December 2018 Anthem Provider Newsletter - NV Medical Policy & Clinical Guidelines Dec 1, 2018

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

December 2018 Anthem Provider Newsletter - NV Medical Policy & Clinical Guidelines Dec 1, 2018

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

December 2018 Anthem Provider Newsletter - NV Medical Policy & Clinical Guidelines Dec 1, 2018

Reimbursement for Convenience Surgical Supply Kits - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Scope of License - Reimbursement Policy Update (Professional)

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

System updates for reimbursement policies in 2019 - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Reimbursement Policies are available online

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Clear Claim Connection

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Coordination of Benefits for an FEP® member

December 2018 Anthem Provider Newsletter - NV Federal Employee Plan (FEP) Dec 1, 2018

New Medicare Advantage provider service phone number beginning January 1, 2019

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

2019 Medicare Advantage individual benefits and formularies

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

When and how to initiate Medicare Advantage reopenings

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

Keep up with Medicare news

December 2018 Anthem Provider Newsletter - NV Medicare Dec 1, 2018

Accessing remittance inquiry beginning December 1, 2018

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Pharmacy management information

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Practitioners’ rights during credentialing process

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Claims Requiring Additional Documentation – Reimbursement Policy Update

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Remittance Inquiry tool available December 1, 2018

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Vaginal birth after cesarean shared decision-making aid available

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Anthem adopts MCG care guidelines for physical health - acute care services and behavioral health services

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Prior authorization requirements for Interferon beta-1a

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Coding spotlight: substance use disorders and smoking

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Procedure codes may be denied

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Quarterly pharmacy formulary change notice

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Improving the Patient Experience continuing medical education

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Quality Management information

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

EDI Gateway migration

December 2018 Anthem Provider Newsletter - NV Medicaid Dec 1, 2018

Case Management Program

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

ConditionCare Program Benefits Patients and Physicians

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Integrated Care Model for plans purchased on the Health Insurance Marketplace / Nevada Health Link benefits patients and physicians

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Coordination of Care

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Important Information about Utilization Management

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Members’ Rights and Responsibilities

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Clinical Practice and Preventive Health Guidelines available on the web

December 2018 Anthem Provider Newsletter - NV Products & Programs Dec 1, 2018

Anthem accepts electronic prior authorization requests for prescription medications online

December 2018 Anthem Provider Newsletter - NV Pharmacy Dec 1, 2018

Introducing the new Clinical Criteria page for injectable, infused or implanted drugs

December 2018 Anthem Provider Newsletter - NV Pharmacy Dec 1, 2018

Pharmacy information available on anthem.com

December 2018 Anthem Provider Newsletter - NV Pharmacy Dec 1, 2018

Request a Clinical Appeal through new functionality in our Interactive Care Reviewer (ICR) tool on Availity

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Availity to serve as EDI entry point for electronic submissions

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Anthem works to simplify payment recovery process for National Accounts membership

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018

Non-participating lab referrals

December 2018 Anthem Provider Newsletter - NV Administrative Dec 1, 2018
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