1. Important Reminders
Mutual of Omaha FAQ’s
Referrals Required even within TriHealth Group; all specialist, home healthcare, outpatient therapy, Cardiac and Pulmonary Rehab
Referral NOT needed: Preventive women’s care (all other requires referral), flu shots, pneumonia vaccine, emergency/urgent care, dialysis, dental, routine eye, audiology evaluations
Portal Issues contact Lumeris or
MoO Follows the Medicare IPO list
The information has been loaded to the Managed Care LinkNet page under the Mutual of Omaha tab.
If you experience any issues with Mutual of Omaha or would like additional training for your team please notify the Managed Care Team-

2. Important Reminders

3. Changes in Medical Non-Oncology Specialty Drug Reviews
Prior to June 15, 2019
                    Action
Contact
Submit a new prior authorization request
Inquire about an existing request
Call AIM at ,
8 a.m. – 5 p.m. or
Access online at 
available 24/7
Changes in Medical Non-Oncology Specialty Drug Reviews
Effective June 15, 2019
Providers will need to submit a new prior authorization request by contacting Anthem’s medical specialty drug review team:
By phone at or
By fax at or
Online access at available 24/7.
What is not changing?
AIM will continue to be responsible for performing medical oncology drug reviews for existing commercial medical benefit for our employer group business.
Medical policies and clinical guidelines for non-drug specialty topics will continue to reside on the Policies webpage on anthem.com.
Post Service Clinical Coverage Reviews and Grievance and Appeals process and teams will not change.
Beginning June 15, 2019
Action
Contact
Submit a new prior authorization request for medical specialty drug reviews
Call Anthem at or
fax us at   or
Access online at available 24/7  
Inquire about an existing request (initially submitted to AIM or Anthem, peer-to-peer review, or reconsideration
Call Anthem at

4. 11/17/2019
New Provider Manual
Effective June 1, 2019, Envolve Pharmacy Solutions will transition to Buckeye Health Plan Medicaid prescription claims processing to RxAdvance from CVS Caremark. As part of this transition, the prior authorization fax number will change
New Buckeye Health Plan Medicaid prior authorization fax number: 
We appreciate your careful attention to this new information. Please contact Buckeye Provider Services at 1–866– with any questions. There is no change to the pharmacy benefits for Buckeye Medicaid members.  The updated Prior Authorization form is available on Buckeye's provider website.