Wisconsin
Provider Communications

October 2019 Anthem Provider News - Wisconsin

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Title Category

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

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

Products & Programs

National Accounts 2020 Pre-certification list*

Administrative

Anthem engages Matrix to conduct mobile health clinics and in-home assessments for targeted members

Administrative

Anthem launches additional changes to anthem.com

Administrative

Updated Provider Manual

Administrative

Important update to Anthem’s commercial drug lists

Pharmacy

Anthem specialty pharmacy medical step therapy drug list- clarification

Pharmacy

Pharmacy information available at anthem.com

Pharmacy

Reimbursement Policy update: Place of Service-Professional*

Reimbursement Policies

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review*

Federal Employee Plan (FEP)

Pre-certification information for the Federal Employee Program*

Federal Employee Plan (FEP)

US Antibiotic Awareness Week is November 11-18, 2019

Federal Employee Plan (FEP)

Medicare News -- October 2019

Medicare

Aspire Telehealth Palliative Care program

Medicare

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

Medicare

Update: 2019 risk adjustment provider trainings

Medicare

Medicare preferred continuous glucose monitors

Medicare

Medical drug Clinical Criteria updates

Medicare

Prior authorization requirements changes effective November 1, 2019

Medicare

New pregnancy notification process using the Availity Portal Benefit Look-Up Tool

Medicaid

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

Medicaid

Authorization process update for identified HCBS procedure codes

Medicaid

New clinical guideline: pneumatic compression devices, effective December 1, 2019

Medicaid

Reimbursement Policy Update: Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

Medicaid

Medical drug Clinical Criteria updates

Medicaid

Prior authorization requirements changes effective November 1, 2019

Medicaid

MCG Care Guidelines update and customizations

Medicaid

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

Medicaid
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