Wisconsin
Provider Communications

Provider Spotlight

Oct 9, 2020

Information from Anthem for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.

Oct 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - October 2020

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.

Sep 29, 2020

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

We are extending cost share waivers for telehealth and telephonic-only care. 


Articles Recent

Title Publication Category Date

Register today for a Racial Trauma Forum hosted by Anthem and Motivo on October 28, 2020

Racial Trauma Forum invitation - Wisconsin Behavioral Health Oct 14, 2020

Information from Anthem for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.
COVID-19 Information - Wisconsin Administrative Oct 9, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - October 2020

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.
October 2020 Anthem Provider News - Wisconsin Administrative Oct 1, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

October 2020 Anthem Provider News - Wisconsin Products & Programs Oct 1, 2020

Anthem updates formulary lists for commercial health plan pharmacy benefit

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

Prior authorization updates for specialty pharmacy are available - October 2020*

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

Updated coverage for breast cancer prevention medications

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

FDA approvals and expedited pathways used - New Molecular Entities (NMEs)

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

Pharmacy information available at anthem.com

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

Update to the Provider Manual

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

National Accounts 2021 Pre-certification list*

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

Anthem Chat: A fast, easy way to have your questions answered

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

New medical claim attachment webinars: Register today

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

Electronic member ID cards available on the Availity portal

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

What Matters Most: Improving the patient experience

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: New guidance on telephone-only service CPT codes for risk adjustment program

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

Medical policy and clinical guideline updates - October 2020*

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Prior authorization update for Commercial Individual Business*

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Transition to AIM rehabilitative service clinical appropriateness guidelines

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Reminder: Expansion of AIM Musculoskeletal Program effective November 1, 2020

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Reimbursement policy update: Emergency department - leveling of Evaluation and Management services (Facility)*

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Claims requiring additional documentation policy (Facility)

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and venipuncture (Professional)*

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Federal Employee Program® expands specialty pharmacy prior authorization list*

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

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

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

Prior authorization requirements for E0482

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

Patient360 enhancement for medical providers

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

Coding spotlight: Providers guide to coding for behavioral health disorders

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

Medicare News - October 2020

View these Medicare articles:
- Evaluation and management services correct coding
- Medical policies and clinical utilization management guidelines update
- Prior authorization requirements for the below codes effective January 2021
October 2020 Anthem Provider News - Wisconsin Medicare Oct 1, 2020

Medical drug benefit clinical criteria updates

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

Prior authorization requirements for the below codes effective January 1, 2021

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

Social determinants of health support expanding with GroundGame Health

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

Provider transparency update

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

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

We are extending cost share waivers for telehealth and telephonic-only care. 
COVID-19 Information - Wisconsin Administrative Sep 29, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - September 2020

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 2020 Anthem Provider News - Wisconsin Administrative Sep 1, 2020

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020*

September 2020 Anthem Provider News - Wisconsin Products & Programs Sep 1, 2020

Meet your Cancer Care Navigator

Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.
September 2020 Anthem Provider News - Wisconsin Products & Programs Sep 1, 2020

Predictive analytics guide proactive support to patients undergoing chemotherapy resulting in lowered admissions

September 2020 Anthem Provider News - Wisconsin Products & Programs Sep 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

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

Specialty pharmacy updates are available - September 2020*

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

New provider directory indicators for medication assisted treatment (MAT) providers

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

EDI Gateway migration deadline is September 15, 2020

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

Providers can now receive and respond to medical record requests for post-pay audit via Change Healthcare’s Assurance Attach Assist Module

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

Enhanced medical records submission process to support claims processing

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

Patient360 adds care gap alert feedback for medical providers

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Prospective Program continues

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

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

September 2020 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Frequency Editing (Professional)*

September 2020 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2020

Medical drug benefit clinical criteria updates

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

Medical policies and clinical utilization management guidelines update

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

What Matters Most online training course: Improving patient experience

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

Update: Notice of changes to the AIM musculoskeletal program

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

Medical drug benefit clinical criteria updates

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

Notice of material changes/amendments to contract and prior authorization changes - August 2020

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.
- Anthem prior authorization updates for specialty pharmacy are available-August 2020*
- Medical Policy and Clinical Guideline Updates-August 2020*
- Expansion of AIM Musculoskeletal Program effective November 1, 2020*
- Reimbursement Policy Update: Claims requiring additional documentation (Facility)*
August 2020 Anthem Provider News - Wisconsin Administrative Aug 1, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

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

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

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

Anthem prior authorization updates for specialty pharmacy are available - August 2020*

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

Pharmacy information available on anthem.com

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

Provider contract and fee schedule notifications coming soon

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

Resources to support diverse patients and communities

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

Evaluation and management services correct coding (Professional)

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

Migrate your EDI transactions to Availity today

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

Electronic claims submission - Clinical Laboratory Improvement Amendments (CLIA)

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

Anthem electronic attachments - X12 275 5010

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

Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

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

Medical record standards

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

Appropriate coding helps provide a comprehensive picture of patients’ health

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

Medical policy and clinical guideline updates - August 2020*

August 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020*

August 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

August 2020 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2020

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

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

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

Medical drug benefit clinical criteria updates

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

New MCG Care Guidelines 24th edition

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

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Wisconsin Medicare Aug 1, 2020

Provider data update

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

Medical drug benefit clinical criteria updates

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

Controlling high blood pressure (CBP)

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

2020 Medicare risk adjustment provider trainings

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

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

Medical drug benefit clinical criteria updates

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

Submit behavioral health authorizations via our online Interactive Care Reviewer tool

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

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

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - July 2020

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 2020 Anthem Provider News - Wisconsin Administrative Jul 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Wisconsin Products & Programs Jul 1, 2020

Updated coverage for HIV PrEP medications

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

Anthem prior authorization updates for specialty pharmacy are available - July 2020*

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

Important change to prior authorization requests for inpatient hospital admissions*

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

Welcome to the Custom Learning Center in Availity

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

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

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

July 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2020

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

Medicare News - July 2020

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

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

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

2020 affirmative statement concerning utilization management decisions

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

Medical drug benefit clinical criteria updates

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

In-Office Assessment Program

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

2020 Special Needs Plans

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

Webinar recording now available for providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Wisconsin Behavioral Health Jun 25, 2020
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