Wisconsin
Provider Communications

Provider Spotlight

Jul 29, 2021

Register for upcoming August CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET

10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET

6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET

Register Now!

 


Articles Recent

Title Publication Category Date

Register for upcoming August CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET

10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET

6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET

Register Now!

 

Clinical Quality CME Webinar Series Continues - Wisconsin Administrative Jul 29, 2021

Register now to learn strategies to help you and your practice improve clinical quality

July 2021 Anthem Provider News - Wisconsin Administrative Jul 1, 2021

Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims

July 2021 Anthem Provider News - Wisconsin Administrative Jul 1, 2021

Proper coding for in-home monitoring can make a measurable difference for INR

July 2021 Anthem Provider News - Wisconsin Administrative Jul 1, 2021

Another mark of the pandemic: An increase in childhood obesity

July 2021 Anthem Provider News - Wisconsin Administrative Jul 1, 2021

How to enroll in electronic fund transfer (EFT) for faster remittance

July 2021 Anthem Provider News - Wisconsin Digital Tools Jul 1, 2021

Electronic claim response files

July 2021 Anthem Provider News - Wisconsin Digital Tools Jul 1, 2021

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

July 2021 Anthem Provider News - Wisconsin Digital Tools Jul 1, 2021

Update: Site of care medical necessity reviews for long-acting colony-stimulating factors not implemented on June 1, 2021*

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

Designated specialty pharmacy network updates effective October 1, 2021*

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

Updates for specialty pharmacy are available - July 2021*

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

Certain specialty medication prior authorization requests may require additional documentation*

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

Medical Policy and Clinical Guideline Updates - July 2021*

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

Reimbursement policy update: Consultations - Professional*

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

Medicaid News - July 2021

View these Medicaid articles:
- Specialty pharmacy prior authorization retraction notice
- Infusion step therapy retraction notice
- Specialty Rx precertification additional documentation notice effective August 1, 2021
- Prior authorization requirement changes effective September 1, 2021–UM AROW 1327
- February 2021 medical policies and utilization management guidelines update
July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

What Matters Most: Improving the patient experience

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Coding spotlight: Mental disorders in childhood

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

March 2021 medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021 - UM AROW 1837

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal Program clinical appropriateness guidelines

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Medicare News - July 2021

View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators Administrative Jun 25, 2021

Information from Anthem for Care Providers about COVID-19 (updated June 9, 2021)

We recently updated information about coverage and cost shares for telephonic-only care.
COVID-19 Information - Wisconsin Administrative Jun 9, 2021

Updates for specialty pharmacy are available - June 2021*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Pharmacy Jun 1, 2021

Keep your contact information current

June 2021 Anthem Provider News - Wisconsin Administrative Jun 1, 2021

Medical policy and clinical guideline updates - June 2021*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Prior authorization for genetic testing medical policy effective September 1, 2021*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM advanced imaging clinical appropriateness guidelines*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM musculoskeletal program clinical appropriateness guidelines*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Update to evaluation and management services correct coding - Professional

June 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jun 1, 2021

DEXA bone scan criteria for the Federal Employee Program®

June 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jun 1, 2021

Medicaid News - June 2021

View these Medicaid articles:
- Medical drug benefit Clinical Criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Complex case management program

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Let’s vaccinate

June 2021 Anthem Provider News - Wisconsin Products & Programs Jun 1, 2021

Designated specialty pharmacy network updates

June 2021 Anthem Provider News - Wisconsin Pharmacy Jun 1, 2021

Pharmacy information available at anthem.com

June 2021 Anthem Provider News - Wisconsin Pharmacy Jun 1, 2021

Answering your claims questions is easier through chat; secure messaging will sunset soon, start using chat now

June 2021 Anthem Provider News - Wisconsin Administrative Jun 1, 2021

Regular check-ins with your clearinghouse could affect timely filing

June 2021 Anthem Provider News - Wisconsin Administrative Jun 1, 2021

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

June 2021 Anthem Provider News - Wisconsin Administrative Jun 1, 2021

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

June 2021 Anthem Provider News - Wisconsin Digital Tools Jun 1, 2021

Submit EDI corrected claims via Availity or EDI

June 2021 Anthem Provider News - Wisconsin Digital Tools Jun 1, 2021

Digital solution options with Availity

June 2021 Anthem Provider News - Wisconsin Digital Tools Jun 1, 2021

Two great learning resources on one secure portal

June 2021 Anthem Provider News - Wisconsin Digital Tools Jun 1, 2021

Reimbursement policy update: Outpatient facility claim edits

June 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jun 1, 2021

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Reimbursement policy reminder: Inpatient readmissions

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Register for upcoming CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

5 Strategies to Improve Your Quality Measures - June 10th, 12 p.m. or 3 p.m. ET
7 Ways to Enhance Your Patients’ Experience - June 17th, 12 p.m. or 3 p.m. ET

Register now!


Clinical Quality CME Webinar Series - Wisconsin Administrative May 27, 2021

Register today for the In Pursuit of Racial Equity: Deconstructing Bias forum hosted by Anthem and Motivo on June 9, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and implicit bias.
Deconstructing Bias Forum Invitation - Wisconsin Administrative May 21, 2021

RETRACTION: AIM Rehabilitative program - initial evaluations and site of service reviews

June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 4, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 2021

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.
May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization*

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

Updates for specialty pharmacy are available - May 2021*

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

Updated 2021 Provider Manual now available

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Resources to support diverse patients and communities

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

2021 Affirmative statement regarding utilization management decisions

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

A helpful and complete guide to covered well-child visits

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

May is National High Blood Pressure Education Month

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Digital online scheduling feature now available in the Availity Portal

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Provider bulletins for medical and itemized bill attachments: Electronic solutions at your fingertips

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

Sending larger digital attachments through Availity

May 2021 Anthem Provider News - Wisconsin Administrative May 1, 2021

New prior authorization requirement: Kidney transplantation*

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

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

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

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews RETRACTION - Please refer to article published May 4, 2021

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

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

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

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

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

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Medicaid news - May 2021

View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Updates to the AIM Specialty Health Musculoskeletal Program Clinical Appropriateness Guidelines
May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Wisconsin Medicare May 1, 2021

Retraction: AIM Rehabilitative program - initial evaluations and site of service reviews

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Reimbursement policy update: Multiple and bilateral surgery - Professional and Facility

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Continuing medical education and continuing education unit opportunities

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Sign up to receive email from Anthem Blue Cross and Blue Shield

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal Program clinical appropriateness guidelines
May 2021 Anthem Provider News - Wisconsin Medicare May 1, 2021

Updates for specialty pharmacy are available - April 2021*

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

Pharmacy information available at anthem.com

April 2021 Anthem Provider News - Wisconsin Pharmacy Apr 1, 2021

Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021

Information Center - Access important policies, forms and helpful resources

April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021
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