Program Announcements

myNEXUS is proud to announce its partnership with Anthem, Inc. to provide utilization management for home health services.

Important Network Delegation Announcement


New Plan Announcement: Effective January 1st, 2019, myNEXUS will manage Group-sponsored Medicare Advantage plans in the states of CA, GA, IN, NH, NY, and OH . Delegated services include Claims Payment, Provider Network, and Utilization Management. Notices for each state can be found by clicking the links below:

California Provider Notice
Georgia Provider Notice
Indiana, New Hampshire, and Ohio Provider Notice
New York Provider Notice


Anthem has posted an initial Network Delegation announcement for Home Health Care services on all Provider newsletters for October 2017. Please select the link below that pertains to your network:

Anthem Blue Cross Blue Shield October 2017 Network Update
Anthem Blue Cross October 2017 Network Update
BlueCross BlueShield of Georgia October 2017 Network Update
Empire BlueCross BlueShield October 2017 Network Update
Amerigroup Washington October 2017 News Bulletin
Amerigroup Texas 2017 Quarter 4 Provider Newsletter
Amerigroup New Mexico 2017 Quarter 4 Provider Newsletter

Phase 1 announcements (Indiana, Kentucky, Ohio and Texas)

All home health service requests for Medicare Advantage members started on or after January 1, 2017 will require prior authorization from myNEXUS. myNEXUS will begin accepting authorization requests on December 19, 2016.

 

Phase 2 announcements (Connecticut, Georgia, Missouri, New York, Virginia)

All home health service requests for Medicare Advantage members started on or after May 1, 2017 will require prior authorization from myNEXUS. myNEXUS will begin accepting authorization requests on April 17, 2017.

Anthem Blue Cross Blue Shield CT, MO, VA 1/31/2017 announcement
Blue Cross Blue Shield of Georgia 1/31/2017 announcement
Empire BlueCross 1/31/2017 announcement

Introduction and Orientation Letter: Connecticut, Missouri and Virginia Medicare Advantage
Introduction and Orientation Letter: Blue Cross Blue Shield of Georgia Medicare Advantage
Introduction and Orientation Letter: Empire BlueCross Medicare Advantage

Phase 3a announcement (California – PPO Only)

All home health service requests for Medicare Advantage members started on or after October 1, 2017 will require prior authorization from myNEXUS. myNEXUS will begin accepting authorization requests on September 18, 2017.

Anthem Blue Cross California 8/15/2017 announcement

Phase 3 announcements (Colorado, Maine, New Hampshire, New Mexico, Wisconsin, Washington)

All home health service requests for Medicare Advantage members started on or after September 1, 2017 will require prior authorization from myNEXUS. myNEXUS will begin accepting authorization requests on August 21, 2017.

Anthem Blue Cross Blue Shield Colorado, Maine, New Hampshire, Wisconsin 6/1/2017 announcement
Amerigroup New Mexico, Washington 6/1/2017 announcement

myNEXUS Home Health Agency Provider – IMPORTANT NETWORK INFORMATION

Please reach out to the Provider Network team with any questions by emailing provider_network@myNEXUScare.com.