Wisconsin
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

July 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jul 1, 2019

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jul 1, 2020

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Apr 1, 2021

2020 FEP® Benefit information available online

January 2020 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 1, 2020

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 1, 2021

Coordination of benefits for an FEP® member

December 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Dec 1, 2019

Federal Employee Program® expands specialty pharmacy prior authorization list*

October 2020 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2020

DEXA bone scan criteria for the Federal Employee Program®

June 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jun 1, 2021

HEDIS 2019 Federal Employee Program® medical record request requirements

February 2019 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Feb 1, 2019

HEDIS 2020 Federal Employee Program® medical record request requirements

April 2020 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Apr 1, 2020

Change in email submission of service requests for Federal Employee Program® members*

*Material Adverse Change (MAC)
August 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Aug 1, 2021

2019 FEP Benefit information available online

December 2018 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Coordination of Benefits for an FEP® member

December 2018 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Benefit change for Infliximab for Federal Employee Program (FEP)

December 2018 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review*

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

Pre-certification information for the Federal Employee Program*

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

Prior authorization requirements for Interferon beta-1a

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Prior authorization requirements for high-level, definitive drug testing

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Medical Policies and Clinical Utilization Management Guidelines update - May 2018

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Medical Policies and Clinical Utilization Management Guidelines update - March 2018

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Vaginal birth after cesarean shared decision-making aid available

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

EDI Gateway migration

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Medicaid News - February 2020

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

Postponed - Review of professional claims with emergency room level 5 E/M codes

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

Resources to support your diverse patient panel

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

New service types added to Availity

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Coding Spotlight: Hypertension

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Electronic claim payment reconsideration

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Medicaid News - December 2020

View these Medicaid article:
- Anti-VEGF Medical Step Therapy Notice
- Important reminder: Coding requirements for reimbursement for early elective deliveries
- Transition to AIM small joint guidelines

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

CAHPS education for providers

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Electronic data interchange (EDI) gateway update

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Notifications on the Availity Portal

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medicaid News - July 2020

View these Medicaid articles:
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Modifier use reminders
- Medical policies and clinical utilization management guidelines update
- New behavioral health discharge call-in line
July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Resources to support your pregnant and postpartum patients and their families

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Medicaid News - April 2021

View these Medicaid articles:
- There is something new happening at Anthem Blue Cross and Blue Shield
- Iron infusion medical step therapy notice
- November 2020 medical policies and utilization management guidelines update
- Prior authorization updates for specialty pharmacy drugs effective April 2021
- Prior authorization required for specialty pharmacy drugs effective May 2021
- Clinical criteria updates notification - November 2020
- Clinical criteria updates notification - December 2020
April 2021 Anthem Provider News - Wisconsin Medicaid Apr 1, 2021

Coming soon: electronic attachments

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Submit behavioral health authorizations via our online Interactive Care Reviewer tool

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Sign up to receive email from Anthem Blue Cross and Blue Shield

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Prior authorization changes

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Coding spotlight: Provider’s guide to coding for cardiovascular conditions

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Update: E&M with Modifier 25 same day as procedure when a prior E&M for the same or similar service has occurred (Professional)

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Medical drug Clinical Criteria updates

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

NCQA: Pharmacy Management Information

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medicaid News -- August 2019

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

NCQA: Practitioners’ Rights during Credentialing Process

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Pharmacy management information

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Use the Provider Maintenance Form for professional providers to update your information

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Coding Spotlight: Substance Use Disorders and Smoking

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

UPDATE: Prior Authorization Requirements for High-Level, Definitive Drug Testing Delayed

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medicaid News -- January 2020

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

August 2019 medical drug benefit clinical criteria updates

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

September 2019 medical drug benefit clinical criteria updates

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Prior Authorization Requirements for Sublocade

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Verifying and updating your provider information

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Coding spotlight: provider’s guide to coding respiratory diseases

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Reimbursement Policy Update: Claims Requiring Additional Documentation

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medicaid News - January 2021

View these Medicaid articles:
- August 2020 Medical Policies and Utilization Management Guidelines update
- Independent laboratory provider – Place of service 81
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirements for Moderate to Deep Anesthesia for Dental Surgery in the Facility Setting
- Policy Update: Nurse Practitioner and Physician Assistant Services
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
- Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines
January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

FDA approvals and expedited pathways used - new molecular entities (NMEs)

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update - January 2018

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Disease Management/Population Health program

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Coding spotlight: HEDIS MY 2021

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

MCG Care Guidelines 24th edition customization

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Updated AIM Rehabilitative program effective August 1, 2021 - Site of Care reviews

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Medicaid News - June 2020

View these Medicaid articles:
- Resources supporting our providers during COVID-19
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
- November 2019 Medical Policies and Clinical Utilization Management Guidelines update
June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Coding spotlight - provider’s guide to code social determinants of health

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

2020 affirmative statement concerning utilization management decisions

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Reimbursement Policy Update Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Wisconsin Medicaid May 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Complex Case Management program

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Important information about utilization management

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Member Rights’ and Responsibilities Statement

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Coding spotlight: provider’s guide to coding behavioral and emotional disorders

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Reimbursement Policy Update: Multiple and Bilateral Surgery, Professional and Facility Reimbursement

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Global 3M19 Medical Policy and Technology Assessment Committee prior authorization requirement updates

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Medicaid News - June 2021

View these Medicaid articles:
- Medical drug benefit Clinical Criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Medicaid news - May 2021

View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Updates to the AIM Specialty Health Musculoskeletal Program Clinical Appropriateness Guidelines
May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Medicaid News - May 2019

May 2019 Anthem Provider Newsletter - Wisconsin Medicaid May 1, 2019

Retraction: AIM Rehabilitative program - initial evaluations and site of service reviews

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Clinical Criteria updates - May 2019

May 2019 Anthem Provider Newsletter - Wisconsin Medicaid May 1, 2019

Reimbursement policy update: Multiple and bilateral surgery - Professional and Facility

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021
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