Wisconsin
Provider Communications

Articles

Title Publication Category Date

Clinical Criteria updates

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

Clinical Criteria updates - May 2019

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

Clinical criteria updates for specialty pharmacy

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

Clinical criteria updates for specialty pharmacy*

February 2019 Anthem Wisconsin Provider Newsletter Pharmacy Feb 1, 2019

Clinical Guideline Update - May 2019*

May 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines May 1, 2019

Clinical Guideline Updates -- September 2019*

September 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Sep 1, 2019

Clinical Laboratory Improvements Amendments for Anthem*

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

Clinical practice and preventive health guidelines

October 2018 Anthem Wisconsin Provider Newsletter Coverage and Clinical Guidelines Sep 28, 2018

Clinical practice and preventive health guidelines available

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

Clinical practice and preventive health guidelines available on anthem.com

December 2018 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Clinical Validation: Professional*

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Wisconsin Medicare Nov 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: 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: 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 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 tip for psychological and neuropsychological testing

December 2019 Anthem Provider News - Wisconsin Behavioral Health Dec 1, 2019

Coming Soon: Anthem Electronic Attachments

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

Coming soon: Electronic attachments

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

Coming soon: electronic attachments

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

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

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

Complex Case Management program

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

Complex discharge planning

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

ConditionCare Program Benefits Patients and Physicians

December 2018 Anthem Wisconsin Provider Newsletter Administrative Dec 1, 2018

Coordination of Benefits for an FEP® member

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

Coordination of benefits for an FEP® member

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

Coordination of Care

December 2018 Anthem Wisconsin Provider Newsletter Administrative Dec 1, 2018

Coordination of care

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

COVID-19 information from Anthem Blue Cross and Blue Shield

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

COVID-19 information repository for Anthem Care Providers

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

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated May 29, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 13, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Wisconsin Administrative May 29, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

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

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Wisconsin Medicare Jun 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

Dual Eligible Special Needs (D-SNP) Plans - provider training required

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

EDI Gateway migration

October 2018 Anthem Wisconsin Provider Newsletter Medicaid Sep 28, 2018

Electric Boat offers Medicare Advantage options

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

Electronic claim payment reconsideration

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

Electronic data interchange (EDI) gateway update

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Electronic Member ID Cards - Easy online access on the Availity Portal

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

Electronic submission is preferred method for requesting pharmacy prior authorization

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

Eligible facilities to bill modifiers JG and TB on 340B drugs

January 2019 Anthem Wisconsin Provider Newsletter Pharmacy Jan 1, 2019

Enhanced search and download options allow easy access to information at your fingertips

Oct. 9, 2019 Anthem Provider News - Wisconsin Administrative Oct 9, 2019

Explore new enhancements to the Availity Education and Reference Center

October 2018 Anthem Wisconsin Provider Newsletter Administrative Sep 28, 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

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Wisconsin Administrative Apr 10, 2020

Find A Doctor -- New Sort Option

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

Follow-Up After Hospitalization for Mental Illness

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

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

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

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

Health Care Reform (including Health Insurance Exchange) Updates and Notifications

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Healthcare Quality Patient Assessment Form and Patient Assessment Form

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

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

HEDIS® 2018 Commercial Results Are In

December 2018 Anthem Wisconsin Provider Newsletter Administrative Dec 1, 2018

HEDIS® 2018: Provider Incentive Winners Announced!

October 2018 Anthem Wisconsin Provider Newsletter Administrative Sep 28, 2018

HEDIS® 2019 starts early February

January 2019 Anthem Wisconsin Provider Newsletter Administrative Jan 1, 2019

HEDIS® 2019: Controlling High Blood Pressure (CBP)

February 2019 Anthem Wisconsin Provider Newsletter Administrative Feb 1, 2019

Help prevent preeclampsia with prenatal aspirin

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

Help protect your patients by providing medical ID protection - best practices

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

Home health billing guidelines for contracted providers

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

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

Important coding reminder for walk-in retail health clinics

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

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Wisconsin Administrative May 29, 2020

Important Information about Utilization Management

December 2018 Anthem Wisconsin Provider Newsletter Administrative Dec 1, 2018

Important information about utilization management

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

Important reminder regarding specialty pharmacy clinical site of care program

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

Important update and clarity regarding National Medical Funding Services

COVID-19 Information - Wisconsin Administrative May 8, 2020

Important update to Anthem’s commercial drug lists

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

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair*

January 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2020

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

Information from Anthem for Care Providers about COVID-19

*Please bookmark/add to favorites Provider News Home for the latest information about COVID-19.
April 2020 Anthem Provider News - Wisconsin Administrative Apr 1, 2020

Information from Anthem for Care Providers about COVID-19 (Updated May 29, 2020)

We recently updated FAQs to reflect the extension of coverage for telehealth and telephonic care.
COVID-19 Information - Wisconsin Administrative May 29, 2020

Integrated Care Model for Plans Purchased on the Health Insurance Marketplace Benefits Patients and Physicians

December 2018 Anthem Wisconsin Provider Newsletter Administrative Dec 1, 2018

Integrated Medical and Behavioral Healthcare Services Billing

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

Interactive Care Reviewer (ICR) New Features

December 2018 Anthem Wisconsin Provider Newsletter Coverage and Clinical Guidelines Dec 1, 2018

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

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

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

Introducing ConcertoHealth

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

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Wisconsin Administrative May 26, 2020

Introducing the New Clinical Criteria Page for Injectable, Infused or Implanted Drugs

December 2018 Anthem Wisconsin Provider Newsletter Pharmacy Dec 1, 2018

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

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

Keep up with Medicare news

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018
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