Wisconsin
Provider Communications

June 2022 Anthem Provider News - Wisconsin

Title	Category
Evaluation and management services for COVID testing - Professional* *Material Adverse Change (MAC)	Administrative
Provider outreach to validate your provider data	Administrative
Forum: Exploring the Intersection of Race and Disability	Administrative
Direct behavioral health fee schedule updates effective July 1, 2022	Administrative
Update use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services	Administrative
Updates to edits associated with implants	Administrative
Once-a-year testing is critically important to providing quality diabetes care	Administrative
CAA: Provider directories accuracy is important	Administrative
Updates to AIM musculoskeletal program: Monitored anesthesia care reviews* *Material Adverse Change (MAC)	Products & Programs
Opioid overdose deaths: What can we do?	Behavioral Health
Specialty pharmacy updates - June 2022* *Material Adverse Change (MAC)	Pharmacy
Medical policy and clinical guideline updates - June 2022* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updated guidance on prior authorization requirements for admissions to in-network long-term acute care hospitals (LTACHs)* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM musculoskeletal clinical appropriateness guidelines* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM advanced imaging clinical appropriateness guidelines* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Updates to AIM sleep disorder management clinical appropriateness guidelines* *Material Adverse Change (MAC)	Medical Policy & Clinical Guidelines
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility* *Material Adverse Change (MAC)	Reimbursement Policies
Process change for Federal Employee Program third-party correspondence requests	Federal Employee Plan (FEP)
Keep up with Medicaid News - June 2022 - Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines - Prior authorization update for select durable medical equipment (DME) items - Prior authorization updates for medications billed under the medical benefit - Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines	Medicaid
Evaluation and management services for COVID testing - professional	Medicaid
New Strategic Provider System will launch in August 2022	Medicaid
Medical drug benefit clinical criteria updates	Medicaid
Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines	Medicaid
Keep up with Medicare News - June 2022	Medicare
Evaluation and management services for COVID testing - professional	Medicare
Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members	Medicare
Medical drug benefit clinical criteria updates	Medicare
Medical policies and clinical utilization management guidelines update	Medicare

Page 1 of 1

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.

Articles by Publication

Articles by Category

Articles by Date

Wisconsin
Provider Communications

June 2022 Anthem Provider News - Wisconsin

Evaluation and management services for COVID testing - Professional*

Provider outreach to validate your provider data

Forum: Exploring the Intersection of Race and Disability

Direct behavioral health fee schedule updates effective July 1, 2022

Update use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services

Updates to edits associated with implants

Once-a-year testing is critically important to providing quality diabetes care

CAA: Provider directories accuracy is important

Updates to AIM musculoskeletal program: Monitored anesthesia care reviews*

Opioid overdose deaths: What can we do?

Specialty pharmacy updates - June 2022*

Medical policy and clinical guideline updates - June 2022*

Updated guidance on prior authorization requirements for admissions to in-network long-term acute care hospitals (LTACHs)*

Updates to AIM musculoskeletal clinical appropriateness guidelines*

Updates to AIM advanced imaging clinical appropriateness guidelines*

Updates to AIM sleep disorder management clinical appropriateness guidelines*

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

Process change for Federal Employee Program third-party correspondence requests

Keep up with Medicaid News - June 2022

Evaluation and management services for COVID testing - professional

New Strategic Provider System will launch in August 2022

Medical drug benefit clinical criteria updates

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

Keep up with Medicare News - June 2022

Evaluation and management services for COVID testing - professional

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

Medical drug benefit clinical criteria updates

Medical policies and clinical utilization management guidelines update

WisconsinProvider Communications

June 2022 Anthem Provider News - Wisconsin

Wisconsin
Provider Communications