Wisconsin
Provider Communications

July 2019 Anthem Provider News - Wisconsin

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Title Category

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.
Administrative

Reminder to providers: Fee schedule information

Administrative

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

Administrative

Anthem Works to Simplify Payment Recovery Process for National Accounts Membership

Administrative

Make the move to the Availity EDI Gateway today

Administrative

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

Administrative

Clinical criteria updates for specialty pharmacy

Pharmacy

Clinical Criteria coding updates for specialty pharmacy are available

Pharmacy

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

Medical Policy & Clinical Guidelines

Clinical Validation: Professional*

Reimbursement Policies

Modifier 79 reminder: Professional

Reimbursement Policies

Modifier 63 reminder: Professional

Reimbursement Policies

ICD-10-CM Coding Guidelines and Laterality: Professional

Reimbursement Policies

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

Federal Employee Plan (FEP)

Outpatient Rehabilitation Program transitioning to AIM

Medicare

Home health billing guidelines for contracted providers

Medicare

Sepsis diagnosis coding and billing reminder

Medicare

Electronic claim payment reconsideration

Medicare

Keep up with Medicare News -- July 2019

Medicare

New service types added to Availity

Medicaid

Electronic claim payment reconsideration

Medicaid

Sepsis diagnosis coding and billing reminder

Medicaid

Coding Spotlight: Hypertension

Medicaid
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