Wisconsin
Provider Communications

November 2020 Anthem Provider News - Wisconsin

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Title Category

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - November 2020

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

IngenioRx Introduces new pharmacy network in 2021

Pharmacy

Prior authorization updates for specialty pharmacy are available - November 2020*

Pharmacy

Availity attachment tools for Anthem and affiliate payers - Live Webinars

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Administrative

Clinical Laboratory Improvement Amendments (CLIA) Number - Additional Information

Administrative

Digital transactions cut administrative tasks in half

Administrative

Get the full picture of your patient’s health through their smartphone

Administrative

US Antibiotic Awareness Week

Administrative

Medical policy and clinical guideline updates - November 2020*

Medical Policy & Clinical Guidelines

Correction to Prior Authorization Update for Commercial business*

Medical Policy & Clinical Guidelines

Reminder: Post-service reviews using AIM

Medical Policy & Clinical Guidelines

New reimbursement policy: Documentation standards for episodes of care (Professional)*

Reimbursement Policies

Reimbursement policy update: Modifier rules (Professional)*

Reimbursement Policies

Reimbursement policy update: Bundled services and supplies (Professional)*

Reimbursement Policies

Medicaid News - November 2020

View these Medicaid article:
- Evaluation and management services correct coding
- New specialty pharmacy medical step therapy requirements
- Provider Chat: A fast, easy way to get your questions answered
- New specialty pharmacy medical step therapy requirements
- Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations
- Electronic visit verification notification
Medicaid

Digital transactions cut administrative tasks in half

Medicaid

Medical drug benefit clinical criteria updates

Medicaid

Prior authorization requirements for HCPCS code 55899

Medicaid

Inhaled nitric oxide reviews for diagnosis-related group admissions

Medicaid

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

Medicaid

Provider transparency update

Medicaid

Coding spotlight: Tips and best practices for compliance

Medicaid

Medicare News - November 2020

View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed
Medicare

Provider Chat: A fast, easy way to get your questions answered

Medicare

Digital transactions cut administrative tasks in half

Medicare

FDA approvals and expedited pathways used - new molecular entities

Medicare
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