CommercialDecember 1, 2018
December 2018 Anthem Wisconsin Provider Newsletter
Administrative
CommercialNovember 30, 2018
Coordination of CareCommercialNovember 30, 2018
Anthem Streamlines Member ID Cards - Use Availity to Verify Members' Cost Shares and Benefits at Time of ServiceCommercialNovember 30, 2018
Availity to Serve as EDI Entry Point for Electronic SubmissionsCommercialNovember 30, 2018
Anthem to Enhance Claim Edits for Outpatient Facility ClaimsCommercialNovember 30, 2018
Anthem Works to Simplify Payment Recovery Process for National Accounts MembershipCommercialNovember 30, 2018
Members Can Shop for Cost-Efficient Health Care Using SmartShopperCommercialNovember 30, 2018
HEDIS® 2018 Commercial Results Are InCommercialNovember 30, 2018
Case Management ProgramCommercialNovember 30, 2018
ConditionCare Program Benefits Patients and PhysiciansCommercialNovember 30, 2018
Integrated Care Model for Plans Purchased on the Health Insurance Marketplace Benefits Patients and PhysiciansCommercialNovember 30, 2018
Important Information about Utilization ManagementCommercialNovember 30, 2018
Members’ Rights and ResponsibilitiesCommercialNovember 30, 2018
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the WebPolicy Updates
CommercialNovember 30, 2018
Restructure of AIM Advanced Imaging Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Update to AIM Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Updates to AIM Musculoskeletal Surgery Clinical Appropriateness GuidelinesCommercialNovember 30, 2018
Interactive Care Reviewer (ICR) New FeaturesCommercialNovember 30, 2018
Clinical practice and preventive health guidelines available on anthem.comCommercialNovember 30, 2018
Medical Polices and Clinical Guidelines Updates - December 2018CommercialNovember 30, 2018
Reimbursement Policy Updates - December 2018CommercialNovember 30, 2018
Reimbursement Policy Update - Scope of License (Professional)CommercialNovember 30, 2018
View reimbursement policies online at anthem.comCommercialNovember 30, 2018
Bundled Services and Supplies (Professional)CommercialNovember 30, 2018
Reimbursement for Convenience Surgical Supply Kits: ProfessionalProducts & Programs
CommercialNovember 30, 2018
2019 FEP Benefit information available onlineCommercialNovember 30, 2018
Coordination of Benefits for an FEP® memberCommercialNovember 30, 2018
Benefit change for Infliximab for Federal Employee Program (FEP)CommercialNovember 30, 2018
Introducing the New Clinical Criteria Page for Injectable, Infused or Implanted DrugsCommercialNovember 30, 2018
Pharmacy Information Available at anthem.comCommercialNovember 30, 2018
Anthem Accepts Electronic Prior Authorization Requests for Prescription Medications OnlineState & Federal
Medicare AdvantageNovember 30, 2018
University of Chicago Offers Medicare Advantage OptionMedicare AdvantageNovember 30, 2018
New Medicare Advantage provider service phone number beginning January 1, 2019Medicare AdvantageNovember 30, 2018
2019 Medicare Advantage individual benefits and formulariesMedicare AdvantageNovember 30, 2018
CMS Medicare Preclusion List effective April 1, 2019Medicare AdvantageNovember 30, 2018
When and how to initiate Medicare Advantage reopeningsMedicare AdvantageNovember 30, 2018
Individual Medicare plans move compound drugs off formulary beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Medicare Part B drugs may include Step Therapy beginning January 1, 2019Medicare AdvantageNovember 30, 2018
Keep up with Medicare newsBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Electronic data interchange (EDI) gateway updateBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019BadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
NCQA: Pharmacy Management InformationBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
NCQA: Practitioners’ Rights during Credentialing ProcessBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Coding Spotlight: Substance Use Disorders and SmokingMedicare AdvantageNovember 30, 2018
Medical Policies and Clinical Utilization Management Guidelines Update-WisconsinBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
UPDATE: Prior Authorization Requirements for High-Level, Definitive Drug Testing DelayedBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Prior authorization requirements for Subcutaneous Implantable Defibrillator systemBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Prior Authorization Requirements for SublocadeBadgerCare Plus and Medicaid SSI ProgramsNovember 30, 2018
Reimbursement Policy Update: Claims Requiring Additional DocumentationTo view this publication online:
Or scan this QR code with your phone