February 1, 2021
February 2021 Anthem Provider News - Wisconsin
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CommercialFebruary 1, 2021
Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - February 2021Notice 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.
CommercialFebruary 1, 2021
New provider directory indicator for telehealth servicesCommercialFebruary 1, 2021
New Anthem utilization management tool now available on Availity: Authorization Rules Lookup toolPolicy Updates
CommercialFebruary 1, 2021
Medical Policy and Clinical Guideline Updates - February 2021*CommercialFebruary 1, 2021
Reimbursement policy update: Emergency Room Transfers - Facility*CommercialFebruary 1, 2021
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*Products & Programs
CommercialFebruary 1, 2021
Anthem to update formulary lists for commercial health plan pharmacy benefitCommercialFebruary 1, 2021
Prior authorization updates for specialty pharmacy are available - February 2021*CommercialFebruary 1, 2021
Pharmacy information available at anthem.comState & Federal
BadgerCare Plus and Medicaid SSI ProgramsFebruary 1, 2021
Medicaid News - February 2021View these Medicaid articles:
- Delay of AIM Musculoskeletal Program guideline updates for Medicaid
- New specialty pharmacy medical step therapy requirements
- Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326
- Delay of AIM Musculoskeletal Program guideline updates for Medicaid
- New specialty pharmacy medical step therapy requirements
- Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326
BadgerCare Plus and Medicaid SSI ProgramsFebruary 1, 2021
Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID CardsBadgerCare Plus and Medicaid SSI ProgramsFebruary 1, 2021
Medical drug benefit clinical criteria updates - February 2021BadgerCare Plus and Medicaid SSI ProgramsFebruary 1, 2021
CAHPS® surveyBadgerCare Plus and Medicaid SSI ProgramsFebruary 1, 2021
HEDIS Measurement Year 2020: Medicaid summary of changes from NCQAMedicare AdvantageFebruary 1, 2021
PN for UM AROW Item 1330Medicare AdvantageFebruary 1, 2021
Medical drug benefit clinical criteria updates - February 2021To view this publication online:
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