CommercialMarch 31, 2023
April 2023 Provider News - Wisconsin
Administrative
CommercialMarch 31, 2023
CAA: Maintain your online provider directory informationCommercialMarch 31, 2023
Authorizations for post-acute care services for Commercial membersCommercialMarch 31, 2023
Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)CommercialMarch 31, 2023
Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialBadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Update use of modifier 25 for billing for visits that include preventive and problem-oriented evaluation and management servicesCommercialMarch 31, 2023
Helping to reduce delays when submitting attachmentsCommercialMarch 31, 2023
Medical Oncology Program ProviderPortal case entry enhancementsCommercialMarch 31, 2023
Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023CommercialMarch 31, 2023
Update to Claim Payment Dispute processCommercialMarch 31, 2023
Submitting prior authorizations is getting easierCommercialMedicare AdvantageMarch 31, 2023
Survey for all skilled nursing facilitiesCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Survey for all skilled nursing facilitiesEducation & Training
BadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Ready, set, renew!Policy Updates
CommercialMarch 31, 2023
Genetic Testing claim editsCommercialMarch 31, 2023
Notification Regarding Reimbursement Changes to COVID-19 Vaccine AdministrationCommercialMarch 31, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialMarch 31, 2023
Reimbursement policy update: Bundled Services and Supplies - ProfessionalProducts & Programs
CommercialMarch 31, 2023
Let’s VaccinateCommercialMedicare AdvantageMarch 31, 2023
Pay Doctor Bill (provider payment option) - General FAQCommercialMarch 31, 2023
HEDIS 2023 Federal Employee Program medical record request requirementsCommercialMarch 31, 2023
FEP Quality Reimbursement Program updateCommercialMarch 31, 2023
Pharmacy information available on our provider websiteState & Federal
BadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measuresBadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Correct coding for hospital outpatient clinic visits for MedicaidBadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023
Keep up with Medicaid News - April 2023- Notification of Pregnancy Incentive Program discontinuation
- Electronic visit verification
- Prior authorization requirement changes
Medicare AdvantageMarch 31, 2023
Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare AdvantageMedicare AdvantageMarch 31, 2023
E-visitsMedicare AdvantageMarch 31, 2023
Keep up with Medicare News - April 2023- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Imjudo, Pedmark, Tecvayli, Tzield, Vegzelma)
- Blue Cross and Blue Shield expands specialty pharmacy precertification list (Elahere)
- New specialty pharmacy medical step therapy requirements (Avastin, Byooviz, Cimerli, Eylea, Lucentis, Vabysmo)
- Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)
- Clinical Criteria updates
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