Wisconsin
Provider Communications

Provider Spotlight

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.


Articles Recent

Title Publication Category Date

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

Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*

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

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

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

Make the move to the Availity EDI Gateway today

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

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2019 Program Year Progression -- What’s in it for you and your patients?

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

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

July 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2019

Clinical Validation: Professional*

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

July 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jul 1, 2019

Outpatient Rehabilitation Program transitioning to AIM

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

Home health billing guidelines for contracted providers

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

Electronic claim payment reconsideration

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

Keep up with Medicare News -- July 2019

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

New service types added to Availity

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

Coding Spotlight: Hypertension

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

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

Anthem to acquire Beacon Health Options

N/A Behavioral Health Jun 6, 2019

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Provider Newsletter - Wisconsin Products & Programs Jun 1, 2019

Anthem expands specialty pharmacy prior authorization list*

June 2019 Anthem Provider Newsletter - Wisconsin Pharmacy Jun 1, 2019

Anthem announces changes in medical non-oncology specialty drug reviews effective June 15, 2019

June 2019 Anthem Provider Newsletter - Wisconsin Pharmacy Jun 1, 2019

AIM programs may require additional prior authorization documentation*

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Anthem Commercial Risk Adjustment (CRA) Reporting Update: Retrospective Program begins; benefits of direct connection access to your EMR

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Find A Doctor -- New Sort Option

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Coming Soon: Anthem Electronic Attachments

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

New ICR Immediate Decision List posted on Availity Payer Spaces

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Anthem launches additional changes to anthem.com for Q2

June 2019 Anthem Provider Newsletter - Wisconsin Administrative Jun 1, 2019

Medical Policy and Clinical Guideline Updates -- June 2019*

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

New Clinical Guideline: Inpatient Inter-Facility Transfers effective September 1, 2019*

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

New Reimbursement Policy: Ambulance Transportation -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Reimbursement Policy Update: Frequency Editing -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Keep up with Medicare News -- June 2019

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

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

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

Medicaid News -- June 2019

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

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

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Complex Case Management program

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Important information about utilization management

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Members' Rights and Responsibilities Statement

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

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

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
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