News & Announcements

Provider Coding Education (CME/CEU) Webinars and on-demand trainings are now available!

Enjoy informative webinars designed specifically for network providers, coders, billers and office staff. A variety of helpful and educational topics relating to coding and documentation, claims and billing issues, member care, quality measures, and more are available

Provider demographics update

Anthem partners with AIM Specialty Health®* (AIM), a leading specialty benefits management company that provides services like radiology, cardiology, genetic testing, oncology, musculoskeletal, rehabilitation, sleep management and additional specialty areas (services vary by state). Partnerships like this require Anthem provider demographic information (group or practice name, additional providers added to the group/practice, location) is current and accurate to avoid provider and member abrasion.

Availity Provider Article and FAQs

Starting April 27, 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.

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..

Pharmacy benefit manager change to IngenioRx

Effective October 1, 2019, IngenioRx will become the pharmacy benefit manager (PBM) for prescription drugs, home delivery pharmacy and specialty pharmacy for Anthem Blue Cross and Blue Shield members.

NPI/Taxonomy Rules

Recent months have resulted in provider reimbursement challenges, most notably with billing according to the NPI/Taxonomy rules as outlined in IHCP bulletin BT201768 which is found at http://provider.indianamedicaid.com/ihcp/Bulletins/BT201768.pdf.

Billing Appropriate NPI and Taxonomy

In an effort to further educate the provider community, Anthem Blue Cross and Blue Shield (Anthem) has added detailed information to the NPI and Taxonomy Bulletin released in June of this year.

Other NPI/Taxonomy Resources

IHCP Provider Bulletin BT201768

Page Last Updated: 01/29/2020