News & Announcements

Availity Provider FAQ and Availity Notification

Starting April 13, 2020, Anthem will launch the use of Availity’s Medical Attachment functionality for electronic communications. This new functionality allows providers to upload medical records and itemized bill information electronically instead of through traditional paper communications. This functionality can improve communications for medical record requests and receipt and will not impact the audit program.

Expansion of Specialty Pharmacy Precertification List: Zirabev

Effective March 23, 2020, the specialty Medicare Part B drug listed in the table below will be included in our precertification review process. Noncompliance with new requirements may result in denied claims

Hospice Billing Instructions

Effective November 1, 2019, hospice services are no longer the responsibility of the participating medical group (PMG)

New specialty pharmacy network for Anthem Blue Cross

Effective 2/1/19, Anthem Blue Cross announces the launch of a new specialty pharmacy network for Anthem members. The new network provides the special care needed when a specialty drug is dispensed.

Pharmacy benefit manager change to IngenioRx

Earlier this year, we announced the launch of IngenioRx, our new pharmacy benefits manager (PBM). Effective January 1, 2020, IngenioRx will start serving our Anthem Blue Cross members’ prescription drug coverage.

MMP - Clinical Criteria Web Posting September 2019

On September 19, 2019, the Pharmacy and Therapeutics (P&T) Committee approved the following Clinical Criteria applicable to the medical drug benefit for Anthem Blue Cross. These policies were developed, revised or reviewed to support clinical coding edits.

Clinical Criteria Web Posting September 2019

On September 19, 2019, the Pharmacy and Therapeutics (P&T) Committee approved the following Clinical Criteria applicable to the medical drug benefit for Anthem Blue Cross. These policies were developed, revised or reviewed to support clinical coding edits.

Screening for perinatal and postpartum depression

Beginning July 1, 2019, providers of obstetrical care are required to screen or offer to screen women for perinatal mood disorders, including depression.

New! Demographic Updates Made Easy

Anthem Blue Cross providers should update provider demographic information online via the revised Provider Maintenance Form. Update options include: adding an address location, changing a name or tax ID, provider leaving a group or a single location, adding and updating phone/fax numbers, closing a practice location, and more. Visit the form page to review more update options.

Provider Website Survey

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