CommercialDecember 30, 2022

January 2023 Anthem Provider News - Wisconsin

Administrative

AdministrativeCommercialDecember 30, 2022

Professional system updates for 2023

AdministrativeCommercialDecember 30, 2022

Outpatient system updates for 2023

AdministrativeCommercialMedicare AdvantageDecember 30, 2022

Notification regarding reimbursement changes to COVID-19 laboratory services codes

AdministrativeCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Engagement with your patient counts

AdministrativeCommercialMedicare AdvantageDecember 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

AdministrativeCommercialDecember 30, 2022

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

Digital SolutionsCommercialDecember 30, 2022

Submitting prior authorizations digitally through Interactive Care Reviewer

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update*
*Material adverse change (MAC)

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines

Reimbursement PoliciesCommercialDecember 30, 2022

Outpatient facility revenue code billing requirements

Products & Programs

Federal Employee Program (FEP)CommercialDecember 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases*
*Material adverse change (MAC)

PharmacyCommercialDecember 30, 2022

Specialty pharmacy updates

State & Federal

State & FederalBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Attention physicians and lab providers: COVID-19 update regarding reimbursement

State & FederalBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

State & FederalBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Monkeypox and smallpox vaccines: Product code on claims

State & FederalBadgerCare Plus and Medicaid SSI ProgramsDecember 30, 2022

Keep up with Medicaid News - January 2023
- This is Quitting: Helping teens and young adults quit vaping
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

State & FederalMedicare AdvantageDecember 30, 2022

Cleveland-Cliffs offers Medicare Advantage option

State & FederalMedicare AdvantageDecember 30, 2022

Keep up with Medicare news - January 2023
- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines