Wisconsin
Provider Communications

Articles

Title Publication Category Date

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

Medicare News -- October 2019

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

Aspire Telehealth Palliative Care program

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

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

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

Update: 2019 risk adjustment provider trainings

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

Medicare preferred continuous glucose monitors

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

Medical drug Clinical Criteria updates

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

Prior authorization requirements changes effective November 1, 2019

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- September 2019

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.
September 2019 Anthem Provider News - Wisconsin Administrative Sep 1, 2019

Reminder: Changes to timely filing requirements coming in October

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

Provider Transparency Update

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

Anthem launches Sydney on September 1; new app offers better digital health care support to members

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

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

Claims requiring additional documentation facility reimbursement policy update

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

PCP after-hours access requirements

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

Clinical criteria and prior authorization updates for specialty pharmacy are available*

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

Access requirements for behavioral health care services

September 2019 Anthem Provider News - Wisconsin Behavioral Health Sep 1, 2019

Clinical Guideline Updates -- September 2019*

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

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

Medicare News -- September 2019

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

Coming soon: Electronic attachments

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

Clinical Criteria updates

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

Customizations to the 23rd edition of the MCG Care Guidelines

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

Changes to prior authorization (PA) requirements

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

Pharmacy benefit manager change to IngenioRx

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

Coming soon: electronic attachments

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

Prior authorization changes

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

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

Medicaid News -- August 2019

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

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- August 2019

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.
August 2019 Anthem Provider News - Wisconsin Administrative Aug 1, 2019

New location for Provider Manuals on anthem.com

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

Update: Sepsis Coding

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

REMINDER: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

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

Pharmacy information available at anthem.com

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

Medical Policy and Clinical Guideline Updates -- August 2019*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Anthem customizations to MCG care guidelines 23rd edition*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Reimbursement Policy Update: Bundled Services-Professional*

August 2019 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2019

Reimbursement Policy Update: Frequency Editing-Professional*

August 2019 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2019

Medicare News -- August 2019

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

New service types added to Availity

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

AIM Specialty Health programs may require documentation

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

Special needs plans - provider training required

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

UPDATE: New Rehabilitative Program remains temporarily delayed

Anthem Wisconsin UPDATE: New Rehabilitative Program remains temporarily delayed Products & Programs Jul 16, 2019

UPDATE: new Rehabilitative Program now effective August 1, 2019

Anthem Wisconsin UPDATE: new Rehabilitative Program now effective August 1, 2019 Products & Programs Jul 3, 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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- July 2019

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.
July 2019 Anthem Provider News - Wisconsin Administrative Jul 1, 2019

Reminder to providers: Fee schedule information

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

Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*

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

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

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

Make the move to the Availity EDI Gateway today

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression -- What’s in it for you and your patients?

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

Clinical criteria updates for specialty pharmacy

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

Clinical Criteria coding updates for specialty pharmacy are available

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

Clinical Validation: Professional*

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

Modifier 79 reminder: Professional

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

Modifier 63 reminder: Professional

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

ICD-10-CM Coding Guidelines and Laterality: Professional

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

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

Outpatient Rehabilitation Program transitioning to AIM

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

Home health billing guidelines for contracted providers

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

Keep up with Medicare News -- July 2019

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

Coding Spotlight: Hypertension

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- June 2019

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 starred (*) below.
June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Provider Newsletter - Wisconsin Products & Programs Jun 1, 2019

Anthem expands specialty pharmacy prior authorization list*

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

Anthem announces changes in medical non-oncology specialty drug reviews effective June 15, 2019

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

AIM programs may require additional prior authorization documentation*

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program begins; benefits of direct connection access to your EMR

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

Find A Doctor -- New Sort Option

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

Coming Soon: Anthem Electronic Attachments

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

New ICR Immediate Decision List posted on Availity Payer Spaces

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

Anthem launches additional changes to anthem.com for Q2

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

Medical Policy and Clinical Guideline Updates -- June 2019*

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

New Clinical Guideline: Inpatient Inter-Facility Transfers effective September 1, 2019*

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

New Reimbursement Policy: Ambulance Transportation -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Reimbursement Policy Update: Frequency Editing -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Keep up with Medicare News -- June 2019

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

Review of professional claims with emergency department level 5 E&M codes

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

Why do patients stop taking their prescribed medications and what can you do to help them?

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

Medicaid News -- June 2019

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