Wisconsin
Provider Communications

June 2019 Anthem Provider Newsletter - Wisconsin

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Title Category

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.
Administrative

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

Products & Programs

Anthem expands specialty pharmacy prior authorization list*

Pharmacy

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

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

AIM programs may require additional prior authorization documentation*

Administrative

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

Administrative

Find A Doctor -- New Sort Option

Administrative

Coming Soon: Anthem Electronic Attachments

Administrative

New ICR Immediate Decision List posted on Availity Payer Spaces

Administrative

Anthem launches additional changes to anthem.com for Q2

Administrative

Medical Policy and Clinical Guideline Updates -- June 2019*

Medical Policy & Clinical Guidelines

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

Medical Policy & Clinical Guidelines

New Reimbursement Policy: Ambulance Transportation -- Professional*

Reimbursement Policies

Reimbursement Policy Update: Frequency Editing -- Professional*

Reimbursement Policies

Keep up with Medicare News -- June 2019

Medicare

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

Medicare

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

Medicare

Medicaid News -- June 2019

Medicaid

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

Medicaid

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

Medicaid

Complex Case Management program

Medicaid

Important information about utilization management

Medicaid

Members' Rights and Responsibilities Statement

Medicaid
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