News & Announcements

Rituxan Biosimilars Medical Step Therapy Notice

January 1, 2021, the following specialty pharmacy drugs and corresponding codes from current Clinical Criteria will be included in our medical step therapy precertification review process.

 

 

Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology

The following updates will apply to the AIM Specialty Health Clinical Appropriateness Guidelines for Radiation Oncology for claims with dates of service on and after March 14, 2021. AIM Specialty Health is an independent company providing utilization review service on behalf of BlueChoice HealthPlan.

 

Sign up to receive email from HealthKeepers, Inc.

In order to communicate more efficiently with providers, HealthKeepers, Inc. is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email. Email is the quickest and most direct way to receive important information from HealthKeepers, Inc.

 

Expansion Open Enrollment 2020

 

Notification regarding inhaled nitric oxide

The purpose of this notification is to inform participating hospitals that the use of inhaled nitric oxide (iNO) during an inpatient stay will be reviewed for medical necessity using our Clinical Utilization Management (UM) Guideline for Inhaled Nitric Oxide, CG-MED-69. iNO is a covered service for eligible members when the use of iNO meets medical necessity criteria.

 

CCC plus Open Enrollment

Please note, this communication applies to Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) offered by HealthKeepers, Inc. Thank you for being an Anthem HealthKeepers Plus provider and supporting our members.

 

Change to transportation vendor

Effective August 1, 2020, Southeastrans will no longer provide transportation services for members enrolled in Anthem HealthKeepers Plus and Anthem CCC Plus. The new transportation vendor, Access2Care,* will be open 24/7, 365 days of the year.

 

Department of Health and Human Services announces additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program providers (June 15, 2020)

HealthKeepers, Inc. is closely monitoring COVID-19 developments how they will impact our Anthem HealthKeepers Plus members and our health care provider partners. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part.

 

Prior authorization requirements for angiographic evaluation of stenotic or thrombosed dialysis circuits

Effective August 1, 2020, HealthKeepers, Inc. will change prior authorization (PA) requirements for angiographic evaluation of stenotic or thrombosed dialysis circuits.

 

 

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Effective for dates of service on and after August 16, 2020, the following updates will apply to the AIM Specialty Health®* (AIM) Sleep Disorder Management Clinical Appropriateness Guideline.

 

Provider Orientations

You and your staff are invited to a webinar covering information for members enrolled in Anthem HealthKeepers Plus; the Medallion 4.0 Medicaid Managed Care program and Anthem CCC Plus.

 

Availity Provider FAQ and Availity Notification

Starting March 9, 2020, HealthKeepers, Inc. will launch the use of Availity’s Medical Attachment functionality for Anthem HealthKeepers Plus 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.

 

 

Update: electronic visit verification transition period extended

The Department of Medical Assistance Services (DMAS) announced they have extended the electronic visit verification (EVV) implementation transition period to ensure providers can successfully comply with the EVV requirements. DMAS has extended this period through March 31, 2020. During this transition period, agency providers will continue to be reimbursed for Anthem HealthKeepers Plus claims that do not meet EVV compliance requirements by HealthKeepers, Inc.

 

New! Demographic Updates Made Easy

Anthem HealthKeepers Plus 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 Maintenance Form


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