Wisconsin
Provider Communications

February 2021 Anthem Provider News - Wisconsin

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Title Category

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - February 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
Administrative

New provider directory indicator for telehealth services

Administrative

New Anthem utilization management tool now available on Availity: Authorization Rules Lookup tool

Administrative

Medicaid News - February 2021

View these Medicaid articles:
- Delay of AIM Musculoskeletal Program guideline updates for Medicaid
- New specialty pharmacy medical step therapy requirements
- Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326
Medicaid

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards

Medicaid

Medical drug benefit clinical criteria updates - February 2021

Medicaid

CAHPS® survey

Medicaid

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

Medicaid

Medical Policy and Clinical Guideline Updates - February 2021*

Medical Policy & Clinical Guidelines

PN for UM AROW Item 1330

Medicare

Medical drug benefit clinical criteria updates - February 2021

Medicare

Anthem to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Prior authorization updates for specialty pharmacy are available - February 2021*

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Reimbursement policy update: Emergency Room Transfers - Facility*

Reimbursement Policies

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

Reimbursement Policies
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