Wisconsin
Provider Communications

Provider Spotlight

Jan 7, 2022

Important COVID-19 update: Prior authorization and other policy adjustments (updated January 7, 2022)

We recently updated prior authorization requirements for patient transfers from acute inpatient hospitals to skilled nursing, acute rehabilitation, and long term acute care hospital facilities.

Dec 30, 2021

Information from Anthem for Care Providers about COVID-19 (updated December 30, 2021)

We recently updated information about coverage dates for telephonic-only care.


Articles Recent

Title Publication Category Date

Important COVID-19 update: Prior authorization and other policy adjustments (updated January 7, 2022)

We recently updated prior authorization requirements for patient transfers from acute inpatient hospitals to skilled nursing, acute rehabilitation, and long term acute care hospital facilities.
COVID-19 Information - Wisconsin Administrative Jan 7, 2022

New Medicare Advantage plan will have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing providers nationally

Effective April 1, 2022, approximately 200,000 Medicare-eligible City of New York retirees across the United States will transition to the NYC Medicare Advantage Plus plan and have access to Blue Cross Blue Shield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

Important Update for New 200k Group Retiree PPO Plan - Wisconsin Administrative Jan 5, 2022

Updated BlueCard® Program Provider Manual available January 1, 2022

January 2022 Anthem Provider News - Wisconsin Administrative Jan 1, 2022

Well-child visits: Know the numbers

January 2022 Anthem Provider News - Wisconsin Administrative Jan 1, 2022

Submitting prior authorizations is getting easier

Anthem is transitioning to the Availity Authorization app
January 2022 Anthem Provider News - Wisconsin Digital Tools Jan 1, 2022

Is prior authorization required?

Answering your questions about the new Availity Authorization App
January 2022 Anthem Provider News - Wisconsin Digital Tools Jan 1, 2022

Reimbursement policy update: Multiple diagnostic imaging facility*

*Material Adverse Change (MAC)
January 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2022

2022 FEP benefit information available online

January 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 1, 2022

Keep up with Medicaid News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines updates
- Specialty pharmacy site of care
- Prior authorization updates for medications billed under the medical benefit
January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

The Behavioral Health Areas of Expertise Profile improves the referral process

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Botox update for Anthem members

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Keep up with Medicare News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
- Medical step therapy updates
- Anthem expands specialty pharmacy precertification list
January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Important update on Botox® for Anthem Medicare members

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Information from Anthem for Care Providers about COVID-19 (updated December 30, 2021)

We recently updated information about coverage dates for telephonic-only care.
COVID-19 Information - Wisconsin Administrative Dec 30, 2021

Plans accessing BlueHPN network go live January 1, 2022

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

Important information about utilization management

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

Case management program

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

Specialty pharmacy updates - December 2021*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Pharmacy Dec 1, 2021

Medical policy and clinical guideline updates - December 2021*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

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

Medical policies and clinical utilization management guidelines update

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

Prior authorization requirement changes effective December 1, 2021

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

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

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

Reimbursement policy update: Drug screen testing

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

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 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

2022 Medicare Advantage service area and benefit updates

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

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

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

Professional system updates for 2022

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

Outpatient system updates for 2022

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

Chlamydia is asymptomatic. Only through screening will we know for sure

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

Behavioral healthcare appointment access requirements

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

Importance of PCP after-hours messaging

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

Member rights and responsibilities

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

Coordination of care

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

Clinical practice and preventive health guidelines available on anthem.com

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

Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021
December 2021 Anthem Provider News - Wisconsin Digital Tools Dec 1, 2021

Pharmacy information available at anthem.com

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

Reimbursement policy update: Virtual Visits - Professional and Facility

December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Keep up with Medicare News - December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

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

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

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

Reimbursement policy update: Drug screen testing

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

Good news: Non-payment remittance advice enhancements are here

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

Somatus is your resource for kidney care management

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

Register today for a forum on Grief and Loss: The disproportionate impact of the pandemic on communities of color

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about the disproportionate impact of the pandemic on communities of color.
Grief & Loss Forum - Wisconsin Administrative Nov 29, 2021

CME credits available in 2021 for a variety of clinical quality webinars - register now!

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

Join Anthem in talking about racism and its impact on health, and earn continuing education credits!

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

Include referring provider name and NPI on home infusion therapy and ambulatory infusion suite professional claims

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

Change in coverage for continuous glucose monitors for some fully insured groups

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

Time to prepare for HEDIS medical record review

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

Reducing the burden of medical record review and improving health outcomes with ECDS reporting

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

Be Antibiotics Aware: Protect your patient

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

Surprisingly easy ways to help patients quit smoking cigarettes

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

Against medical advice (AMA) discharge physician tracking tool

November 2021 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2021

EnrollSafe is available: Our new electronic funds transfer enrollment portal for Anthem providers

EnrollSafe replaces CAQH Enrollhub effective November 1, 2021
November 2021 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2021

Update regarding annual wellness visits for ACA-compliant health plans

November 2021 Anthem Provider News - Wisconsin Products & Programs Nov 1, 2021

Important update on Botox for Anthem members

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

Keep up with Medicare News - November 2021

View these Medicare articles:
- Anthem expands specialty pharmacy prior authorization list
November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Anthem offering Advance Medical Directives program for 2022

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

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

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

New York City Medicare Advantage announcement

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

Clinical criteria updates

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

Electronic data interchange process

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

Updated provider manual

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

Specialty pharmacy updates are available - November 2021*

*Material Adverse Change (MAC)
November 2021 Anthem Provider News - Wisconsin Pharmacy Nov 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Provider News - Wisconsin Reimbursement Policies Nov 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

Electronic data interchange process

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

Claims editing update for ICD-10-CM Excludes1 notes

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

Clinical criteria updates

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

Unspecified diagnosis reminder

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

Reimbursement policy update: Corrected claims

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

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

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

Join The Fenway Institute for a CME webinar about improving your LGBTQIA+ patient interactions

Join a live webinar, “LGBTQIA+ Care: Delivering Trust and Belonging with Every Interaction,” presented by the National LGBTQIA+ Health Education Center at The Fenway Institute. 

Gain LGBTQIA+ Patient Interaction Knowledge - Wisconsin Administrative Oct 21, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 2021

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management


Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Clinical Quality CME Webinar Series Continues - Wisconsin Administrative Oct 5, 2021

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

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

New BlueHPN network plans available for employee open enrollment Fall 2021

October 2021 Anthem Provider News - Wisconsin Products & Programs Oct 1, 2021

Specialty pharmacy updates are available - October 2021*

*Material Adverse Change (MAC)
October 2021 Anthem Provider News - Wisconsin Pharmacy Oct 1, 2021

Designated specialty pharmacy network updates effective January 1, 2022*

*Material Adverse Change (MAC)
October 2021 Anthem Provider News - Wisconsin Pharmacy Oct 1, 2021

Medical policy and clinical guideline updates - October 2021*

*Material Adverse Change (MAC)

October 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2021

Continuation of skilled nursing facility (SNF) program in Wisconsin

October 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2021

Reimbursement policy clarification: Claims requiring additional documentation - Facility

October 2021 Anthem Provider News - Wisconsin Reimbursement Policies Oct 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

Diabetes testing and screening HEDIS measures

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

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

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

New reimbursement policy: Sexually transmitted infections testing (Professional)

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

Prior authorization updates for specialty pharmacy

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