Wisconsin
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

2020 affirmative statement concerning utilization management decisions

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

4 things you can do to encourage cancer screenings for your female patients

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Access to more claim denial information is now self-service

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

Anthem fights opioid addiction: Extension for Community Health Care Outcomes and Quality Medication-Assisted Therapy

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Antibiotic dispensing guidelines

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Aspire Health for members in need of palliative care

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

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

August 2019 medical drug benefit clinical criteria updates

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

Authorization process update for identified HCBS procedure codes

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

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

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

CAHPS education for providers

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

CAHPS® survey

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Clinical Criteria updates

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Clinical criteria updates

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Clinical Criteria updates - May 2019

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

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

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

Coding Spotlight: Cancer - a provider’s guide to properly code cancers

March 2019 Anthem Provider Newsletter - Wisconsin Medicaid Mar 1, 2019

Coding spotlight: Diabetes - provider guide to coding the diagnosis and treatment of diabetes

February 2019 Anthem Wisconsin Provider Newsletter Medicaid Feb 1, 2019

Coding spotlight: HEDIS MY 2021

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

Coding spotlight: HIV and AIDS

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Coding Spotlight: Hypertension

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

Coding spotlight: Mental disorders in childhood

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

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

Coding spotlight: Providers guide to coding for behavioral health disorders

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

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

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

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

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

Coding spotlight: provider’s guide to coding respiratory diseases

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

Coding Spotlight: Substance Use Disorders and Smoking

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Coding spotlight: Tips and best practices for compliance

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Coding tip for psychological and neuropsychological testing

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Coming soon: electronic attachments

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

Complex Case Management program

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Complex Case Management program

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

Complex case management program

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

Continuing medical education and continuing education unit opportunities

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

Controlling high blood pressure (CBP)

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

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

Diabetes testing and screening HEDIS measures

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Digital transactions cut administrative tasks in half

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

Disease Management can help you care for patients with chronic health care needs

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Disease Management/Population Health program

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

EDI Gateway migration

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Electronic claim payment reconsideration

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

Electronic data interchange (EDI) gateway update

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Electronic data interchange process

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Provider News - Wisconsin Medicaid Nov 1, 2019

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

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

Follow-Up After Hospitalization for Mental Illness

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

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

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

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

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Help prevent preeclampsia with prenatal aspirin

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Important information about utilization management

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Important information about utilization management

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

Important information about utilization management

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

Inhaled nitric oxide reviews for diagnosis-related group admissions

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Introducing a new clinical criteria webpage for injectable, infused or implanted drugs covered under the medical benefit

February 2019 Anthem Wisconsin Provider Newsletter Medicaid Feb 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Keep up with Medicaid News - December 2021

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit Clinical Criteria updates
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Keep up with Medicaid News - November 2021

View these Medicaid articles:
- Prior authorization updates for specialty pharmacy
November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Keep up with Medicaid News - October 2021

View these Medicaid articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 medical policies and utilization management guidelines update
October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Keep up with Medicaid news  - September 2021

View these Medicaid articles:
- Clinical Criteria Updates Notification – May 2021
- CT to detect coronary artery calcification — AIM transition
September 2021 Anthem Provider News - Wisconsin Medicaid Sep 1, 2021

Keeping up with routine vaccination during COVID-19

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

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

March 2021 medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

MCG Care Guidelines 24th edition customization

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

MCG Care Guidelines 25th Edition

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

MCG Care Guidelines update and customizations

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Medicaid News - April 2020

View these Medicaid notices:
- November 2019 Medical Policies and Clinical Utilization Management Guidelines update
- Personal care prior authorization
- Prior authorization requirements for A6550 and A9278
April 2020 Anthem Provider News - Wisconsin Medicaid Apr 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

Medicaid News - August 2020

View this Medicaid article:
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Medicaid News - August 2021

View these Medicaid articles:
-Iron Infusion Step Therapy
-Prior authorization requirement changes effective September 1, 2021 – UM AROW 1837
-Iron Infusion Prior Authorization Update
August 2021 Anthem Provider News - Wisconsin Medicaid Aug 1, 2021

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

Medicaid News - February 2020

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

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
February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

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

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

Medicaid News - July 2021

View these Medicaid articles:
- Specialty pharmacy prior authorization retraction notice
- Infusion step therapy retraction notice
- Specialty Rx precertification additional documentation notice effective August 1, 2021
- Prior authorization requirement changes effective September 1, 2021–UM AROW 1327
- February 2021 medical policies and utilization management guidelines update
July 2021 Anthem Provider News - Wisconsin Medicaid Jul 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

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 2019

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

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

Medicaid News - November 2020

View these Medicaid article:
- Evaluation and management services correct coding
- New specialty pharmacy medical step therapy requirements
- Provider Chat: A fast, easy way to get your questions answered
- New specialty pharmacy medical step therapy requirements
- Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations
- Electronic visit verification notification
November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Medicaid News -- August 2019

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

Medicaid News -- January 2020

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

Medicaid News -- June 2019

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Medical drug benefit clinical criteria updates

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

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Wisconsin Medicaid Sep 1, 2020

Medical drug benefit clinical criteria updates

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Medical drug benefit clinical criteria updates

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

Medical drug benefit Clinical Criteria updates - December 2019

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021
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