Wisconsin
Provider Communications

Provider Spotlight

Nov 1, 2019

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

Nov 1, 2019

Additional improvements coming to anthem.com


Articles Recent

Title Publication Category Date

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

Additional improvements coming to anthem.com

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

Appropriate coding helps provide a comprehensive picture of patients’ health

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

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Provider News - Wisconsin Products & Programs Nov 1, 2019

Anthem clinical criteria and prior authorization updates for specialty pharmacy are available*

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

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

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

Medical Policy and Clinical Guidelines Updates -- November 2019*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Medicare News -- November 2019

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

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

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

CMS reminder: expedited/urgent requests

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

Electronic submission is preferred method for requesting pharmacy prior authorization

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

New Reimbursement Policy: Update Drug Screen Testing

November 2019 Anthem Provider News - Wisconsin Medicaid Nov 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

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

Anthem launches additional changes to anthem.com

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

Updated Provider Manual

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

New pregnancy notification process using the Availity Portal Benefit Look-Up Tool

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

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

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

Authorization process update for identified HCBS procedure codes

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

New clinical guideline: pneumatic compression devices, effective December 1, 2019

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

Reimbursement Policy Update: Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

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

Medical drug Clinical Criteria updates

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

Prior authorization requirements changes effective November 1, 2019

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

MCG Care Guidelines update and customizations

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

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

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

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

October 2019 Anthem Provider News - Wisconsin Products & Programs Oct 1, 2019

National Accounts 2020 Pre-certification list*

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

Anthem engages Matrix to conduct mobile health clinics and in-home assessments for targeted members

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

Important update to Anthem’s commercial drug lists

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

Anthem specialty pharmacy medical step therapy drug list- clarification

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

Pharmacy information available at anthem.com

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

Reimbursement Policy update: Place of Service-Professional*

October 2019 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2019

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

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

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

Customizations to the 23rd edition of the MCG Care Guidelines

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

Medical drug Clinical Criteria updates

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 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

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

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

New Reimbursement Policy: Drug Screen Testing

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

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

Update: Sepsis Coding

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

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

August 2019 Anthem Provider News - Wisconsin Pharmacy 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

Sepsis diagnosis coding and billing reminder

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

Clinical Criteria coding updates for specialty pharmacy are available

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

Clinical criteria updates for specialty pharmacy

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

Reminder to providers: Fee schedule information

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