Wisconsin
Provider Communications

December 2020 Anthem Provider News - Wisconsin

Title	Category
Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - December 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.	Administrative
Access requirements for behavioral health care services	Behavioral Health
Prior authorization updates for specialty pharmacy are available - December 2020*	Pharmacy
AIM IVR changes for non-oncology medical specialty drug reviews effective Jan. 1, 2021	Pharmacy
Pharmacy information available at anthem.com	Pharmacy
Plans accessing new Blue HPN® network go live Jan. 1, 2021	Administrative
Access to claim denial information is now self-service	Administrative
Updated BlueCard® Program Provider Manual available Jan. 1, 2021	Administrative
2-minute videos to engage patients about preventive care	Administrative
Anthem makes going digital easy with the Provider Digital Engagement Supplement	Administrative
Anthem contracted air ambulance providers for Wisconsin	Administrative
PCP after-hours access requirements	Administrative
Coordination of care	Administrative
Members’ rights and responsibilities	Administrative
Important information about utilization management	Administrative
Case management program	Administrative
Medical policy and clinical guideline updates - December 2020*	Medical Policy & Clinical Guidelines
Anthem expands hospice policy	Medical Policy & Clinical Guidelines
Updates to AIM Cardiology clinical appropriateness guidelines*	Medical Policy & Clinical Guidelines
Updates to AIM Advanced Imaging clinical appropriateness guideline*	Medical Policy & Clinical Guidelines
Updates to AIM Radiation Oncology clinical appropriateness guideline*	Medical Policy & Clinical Guidelines
Transition to AIM Rehabilitative Services clinical appropriateness guidelines	Medical Policy & Clinical Guidelines
Clinical practice and preventive health guidelines available on anthem.com	Medical Policy & Clinical Guidelines
Reimbursement policy update: Bundled services and supplies (Professional)*	Reimbursement Policies
Reimbursement policy update: DRG newborn inpatient stays (Facility)*	Reimbursement Policies
Medicaid News - December 2020 View these Medicaid article: - Anti-VEGF Medical Step Therapy Notice - Important reminder: Coding requirements for reimbursement for early elective deliveries - Transition to AIM small joint guidelines	Medicaid
CAHPS education for providers	Medicaid
Notifications on the Availity Portal	Medicaid
Resources to support your pregnant and postpartum patients and their families	Medicaid
Sign up to receive email from Anthem Blue Cross and Blue Shield	Medicaid
Digital transactions cut administrative tasks in half	Medicaid
2021 Medicare Advantage individual benefits and formularies	Medicare
Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ	Medicare
Medical policies and clinical utilization management guidelines update	Medicare
Policy Update: Emergency Department: Leveling of Evaluation and Management Services	Medicare
Digital transactions cut administrative tasks in half	Medicare
Transition to AIM small joint guidelines	Medicare

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem websites constitutes your agreement with our Terms of Use.

WisconsinProvider Communications

December 2020 Anthem Provider News - Wisconsin

Wisconsin
Provider Communications