Wisconsin
Provider Communications

Provider Spotlight

May 1, 2019

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 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.


Articles Recent

Title Publication Category Date

Anthem expands specialty pharmacy medical step therapy drug list for agents for hereditary angioedema*

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

Anthem specialty pharmacy medical step therapy drug list clarification about non-oncology colony stimulating factor agents*

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

Pharmacy information available at anthem.com

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

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

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

Review of professional claims with emergency room level 5 E/M codes

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Health Assessment requests for 2019 / Alternative reporting engagement

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

Anthem Contracted Ambulance Providers

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

Attention: Availity launches additional changes to the new look to our Medical Attachment submission tool

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

Updated Provider Manual now available

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

Clinical Guideline Update - May 2019*

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

MCG care guidelines 23rd Edition*

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

Update: Drug Screen Testing - Professional*

May 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies May 1, 2019

Medicaid News - May 2019

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

Clinical Criteria updates - May 2019

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 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.
May 2019 Anthem Provider Newsletter - Wisconsin Administrative May 1, 2019

Keep up with Medicare news - May 2019

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes: April 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.
April 2019 Anthem Provider Newsletter - Wisconsin Administrative Apr 1, 2019

New AIM Rehabilitative program effective July 1, 2019

April 2019 Anthem Provider Newsletter - Wisconsin Products & Programs Apr 1, 2019

Anthem expands specialty pharmacy prior authorization list*

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

New on Interactive Care Reviewer (ICR): Request Clinical Appeals

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

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

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

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

Medical Policy and Clinical Guidelines Updates - April 2019*

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

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline*

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

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines*

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

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines*

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

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines*

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

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

April 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Apr 1, 2019

Update regarding evaluation and management with modifier 25

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 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

Keep up with Medicare news - April 2019

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

Provider surveys

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

November 2018 Medical Policies and Clinical Utilization Management Guidelines update

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

Clinical Criteria updates

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

Help prevent preeclampsia with prenatal aspirin

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

Practitioners’ rights during credentialing process

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

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

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

Change to 835 ERA for all D-SNP MA members for 2019

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

Clinical criteria updates for specialty pharmacy

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

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

Keep up with Medicare news

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

Anthem Commercial Risk Adjustment (CRA) Program Update: Medical chart collection for ACA members due March 31, 2019

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

Some of your patients will begin moving to IngenioRx in Q2 2019

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

Important update to Anthem’s commercial drug lists

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

Anthem launches additional changes to anthem.com in March

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

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

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

Neonatal intensive care unit post-traumatic stress disorder program

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

Clinical criteria updates for specialty pharmacy

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

Important reminder regarding specialty pharmacy clinical site of care program

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

Availity: Explore the updates to the Medical Attachment Tool

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

Availity: New look to Claim Status and Secure Messaging

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

Availity: Latest Updates to EDI Gateway Migration

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

Provider Transparency Update

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

Member Satisfaction with Behavioral Health Outpatient Services (WI)

February 2019 Anthem Wisconsin Provider Newsletter Behavioral Health Feb 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

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes: February 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.
February 2019 Anthem Wisconsin Provider Newsletter Administrative Feb 1, 2019

Clinical criteria updates for specialty pharmacy*

February 2019 Anthem Wisconsin Provider Newsletter Pharmacy Feb 1, 2019

Anthem expands specialty pharmacy prior authorization list*

February 2019 Anthem Wisconsin Provider Newsletter Pharmacy Feb 1, 2019

Anthem expands specialty pharmacy medical step therapy drug list*

February 2019 Anthem Wisconsin Provider Newsletter Pharmacy Feb 1, 2019

Pharmacy information available at anthem.com

February 2019 Anthem Wisconsin Provider Newsletter Pharmacy Feb 1, 2019

HEDIS® 2019: Controlling High Blood Pressure (CBP)

February 2019 Anthem Wisconsin Provider Newsletter Administrative Feb 1, 2019

Update regarding E/M with modifier 25 - Professional*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

Medical Policy and Clinical Guidelines: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Pre-Service/Prior Authorization Clinical Review Update: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Reimbursement Policy Updates: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

Reimbursement Policy Update: Injectable Substances with Related Injection Services - Professional*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

HEDIS 2019 Federal Employee Program® medical record request requirements

February 2019 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Feb 1, 2019

Reminder: Anthem follows Original Medicare policies

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

New specialty Medicare Part B device preferred product program

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Anthem Announces Early Launch of IngenioRx

N/A Pharmacy Jan 30, 2019

New Year Brings New ID Cards - and New ID Numbers - for Many Anthem Members

Jan. 23, 2019 Anthem Wisconsin Provider Network eUpdate Administrative Jan 23, 2019

Anthem ePASS® Weekly Webinar Schedule

Sign up for an ePASS® Weekly Webinar!
Jan. 16, 2019 Anthem Wisconsin Provider Network eUpdate Administrative Jan 16, 2019

Benefits to be available for chronic care management and advance care planning services effective February 23, 2019

January 2019 Anthem Wisconsin Provider Newsletter Administrative Jan 1, 2019

HEDIS® 2019 starts early February

January 2019 Anthem Wisconsin Provider Newsletter Administrative Jan 1, 2019

Simplifying medication prior authorization processes

January 2019 Anthem Wisconsin Provider Newsletter Pharmacy Jan 1, 2019

Update regarding drugs not approved by the FDA

January 2019 Anthem Wisconsin Provider Newsletter Pharmacy Jan 1, 2019

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

January 2019 Anthem Wisconsin Provider Newsletter Pharmacy Jan 1, 2019

Pharmacy information available at anthem.com

January 2019 Anthem Wisconsin Provider Newsletter Pharmacy Jan 1, 2019

Reminder: HCPCS code A0998 Ambulance response and treatment with no transport is active and available for use

January 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Jan 1, 2019

Anthem offers risk adjustment and documentation training

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Transition of Outpatient Rehabilitation Utilization Management program

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

My Diverse Patients - a website to support your diverse patients

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update: January 2019

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

Electronic data interchange (EDI) gateway update

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

NCQA: Pharmacy Management Information

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

NCQA: Practitioners’ Rights during Credentialing Process

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Coding Spotlight: Substance Use Disorders and Smoking

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medical Policies and Clinical Utilization Management Guidelines Update-Wisconsin

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

UPDATE: Prior Authorization Requirements for High-Level, Definitive Drug Testing Delayed

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Prior Authorization Requirements for Sublocade

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Reimbursement Policy Update: Claims Requiring Additional Documentation

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018
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