Wisconsin
Provider Communications

November 2019 Anthem Provider News - Wisconsin

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Title Category

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes -- November 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

Additional improvements coming to anthem.com

Administrative

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

Products & Programs

Anthem clinical criteria and prior authorization updates for specialty pharmacy are available*

Pharmacy

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Medical Policy and Clinical Guidelines Updates -- November 2019*

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

Medical Policy & Clinical Guidelines

Medicare News -- November 2019

Medicare

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

Medicare

CMS reminder: expedited/urgent requests

Medicare

New Reimbursement Policy: Update Drug Screen Testing

Medicaid

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicaid
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