Wisconsin
Provider Communications

December 2022 Anthem Provider News - Wisconsin

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Title Category

CAA: Timely updates help keep our provider directories current

Administrative

Attention lab providers: COVID-19 update regarding reimbursement*

*Material Adverse Change (MAC)
Administrative

Clinical practice and preventive health guidelines available on anthem.com

Administrative

Member assessment of PCP after-hours messaging in 2022

Administrative

Members’ rights and responsibilities

Administrative

Member’s assessment of behavioral healthcare after-hours messaging in 2022

Administrative

Coordination of care

Administrative

Case management program

Administrative

Important information about utilization management

Administrative

IngenioRx will become CarelonRx on January 1, 2023

Administrative

Signature requirements for laboratory orders or requisitions

Administrative

Pharmacy information available on the provider website

Pharmacy

Specialty pharmacy updates - December 2022*

*Material adverse change (MAC)
Pharmacy

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

Medical Policy & Clinical Guidelines

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*

*Material adverse change (MAC)

Medical Policy & Clinical Guidelines

Medical Policies and Clinical Guidelines updates - December 2022*

*Material adverse change (MAC)
Medical Policy & Clinical Guidelines

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

Reimbursement Policies

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Material adverse change (MAC)

Reimbursement Policies

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Material adverse change (MAC)

Reimbursement Policies

Keep up with Medicaid News - December 2022

- Prior authorization requirement changes effective January 1, 2023
- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
- Prior authorization updates for medications billed under the medical benefit (Releuko, Vabysmo)
- Signature requirements for laboratory orders or requisitions
Medicaid

Keep up with Medicare News - December 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- Signature requirements for laboratory orders or requisitions
Medicare

Personal home helper benefit ending

Medicare

2023 Medicare Advantage service area and benefit updates

Medicare
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