By Carol Hoppe, CPC, CCS-P, CPC-I
MedLucid Solutions, LLC
The ISMA is committed to improving relationships with commercial payers and is meeting monthly with Anthem BCBS to address concerns brought to our attention and to share information from Anthem with ISMA members. Here are some opportunities to consider this month.
2021 smoking cessation provider incentive program
Anthem is offering a smoking cessation provider incentive program (SCPIP) to encourage smoking cessation counseling to members who use tobacco, including referring them to Indiana’s Tobacco Quitline. The SCPIP will offer an incentive of
$20, in addition to the reimbursement for the counseling service, to providers who:
- Provide members who use tobacco with intensive smoking/tobacco cessation counseling for greater than 10 minutes; and
- Submit code 4004F in addition to code 99407 — Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes, with modifier U6 — Per 15 minutes and a Primary ICD-10 diagnosis code of F17.200-F17.299.
This additional incentive will be paid
once every calendar year per unique member.
More information on how to qualify for and obtain this additional payment is available
here.
Health needs screening (HNS) provider incentive program (PIP)
Anthem Blue Cross and Blue Shield (Anthem) attempts to complete the Indiana Family and Social Services Administration health needs screening (HNS) with individuals enrolled in Indiana’s Hoosier Healthwise, Hoosier Care Connect or Healthy Indiana Plan (Medicaid members), in order to identify Medicaid members for outreach and engagement in care coordination. Anthem has designed the HNS PIP to encourage providers to assist Medicaid members in completing the HNS and offers an incentive to providers who have Medicaid members complete the HNS at an office visit
during the first 90 days of a member’s enrollment. The HNS is completed
online here. Providers are eligible for the $20 incentive payment once per unique eligible member upon completion of the HNS in the provider’s office. More information on how to qualify for and obtain this additional payment is available
here and
here.
Anthem provider satisfaction surveys
If you have received a provider satisfaction survey from Anthem, please take the opportunity to respond and give specific feedback to make your voice heard. We can only discuss with Anthem what we are aware of, but Anthem wants to hear directly from you. Another survey is coming out soon. An independent vendor will call offices and ask questions about the availability of appointments and other questions. Please prepare your phone staff to transfer the call to the appropriate person who can respond to the questions.
Provider experience managers
Some of the Anthem Medicaid “provider experience managers” (aka provider relations reps) have recently been reassigned, especially in behavioral health. Please see this
updated list to find your current Anthem representatives.
Other updates
REMINDER: The IHCP Annual Seminar was held recently, and
all the of presentations from each Medicaid plan are on the IHCP website. If you were unable to attend or would like copies of any of the presentations, please check them out.
Visit the new Indiana Anthem
provider webpage here. Please bookmark this website for future use.
Effective Sept. 1, 2021, the Indiana Medicaid AIM phone number is
844-767-8158.
Anthem holds a webinar for providers on the third Thursday of each month. The Nov. 18 presentation will cover:
- Using Availity website
- Patient 360
- Interactive care reviewer (ICR)
- Claim appeals
- Additional reminders