News & Announcements

CAQH EnrollHub, which has been temporarily offline, will be operational on January 27, 2020.

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.

 

Medicaid Outpatient Fee Schedule

 

Electronic visit verification claims receiving denial code Z79

Explanation of Payment denial code Z79 — Claim denied for not submitting through designated vendor for VA EVV — was recently implemented in error for Medicaid services requiring electronic visit verification (EVV) when claims were not submitted through our EVV Vendor, Tellus. Claims impacted include those submitted December 5, 2019, through December 17, 2019.

 

Medicaid Expansion Open Enrollment
through December 31!

Medicaid Expansion open enrollment is 11/1-12/31. Don’t wait to switch your health plan.

 

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 HealthKeepers Plus and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) members.

 

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


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.

 

Provider Website Survey

Please help us improve our provider website by taking this brief survey. Your input will help us provide more efficient and effective provider resources.

Complete the survey
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