Wisconsin
Provider Communications

December 2021 Anthem Provider News - Wisconsin

Title	Category
Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date	Administrative
Plans accessing BlueHPN network go live January 1, 2022	Administrative
Professional system updates for 2022	Administrative
Outpatient system updates for 2022	Administrative
Chlamydia is asymptomatic. Only through screening will we know for sure	Administrative
Behavioral healthcare appointment access requirements	Administrative
Importance of PCP after-hours messaging	Administrative
Important information about utilization management	Administrative
Case management program	Administrative
Member rights and responsibilities	Administrative
Coordination of care	Administrative
Clinical practice and preventive health guidelines available on anthem.com	Administrative
Reminder: EnrollSafe is available – electronic funds transfer enrollment portal for Anthem providers EnrollSafe replaced CAQH Enrollhub effective November 1, 2021	Digital Tools
Specialty pharmacy updates - December 2021* *Material Adverse Change (MAC)	Pharmacy
Pharmacy information available at anthem.com	Pharmacy
Medical policy and clinical guideline updates - December 2021* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Advanced Imaging Clinical Appropriateness Guideline* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
RETRACTION: Inpatient Facility Transfers - facility reimbursement policy	Reimbursement Policies
Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional* *Material Adverse Change (MAC)	Reimbursement Policies
New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional* *Material Adverse Change (MAC)	Reimbursement Policies
Reimbursement policy update: Virtual Visits - Professional and Facility	Reimbursement Policies
Keep up with Medicaid News - December 2021 Durable medical equipment prior authorization requirement changes effective December 1, 2021 Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline Medical drug benefit Clinical Criteria updates Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines	Medicaid
Medical policies and clinical utilization management guidelines update	Medicaid
Prior authorization requirement changes effective December 1, 2021	Medicaid
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	Medicaid
Reimbursement policy update: Drug screen testing	Medicaid
Good news: Non-payment remittance advice enhancements are here	Medicaid
HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence	Medicaid
Keep up with Medicare News - December 2021 Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline Medical drug benefit clinical criteria updates Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions New York City Medicare Advantage announcement Medical policies and clinical utilization management guidelines update Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)	Medicare
2022 Medicare Advantage service area and benefit updates	Medicare
Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies	Medicare
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	Medicare
Reimbursement policy update: Drug screen testing	Medicare
Good news: Non-payment remittance advice enhancements are here	Medicare
Somatus is your resource for kidney care management	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 2021 Anthem Provider News - Wisconsin

Wisconsin
Provider Communications