CommercialJuly 1, 2020

July 2020 Anthem Provider News - Wisconsin

Administrative

AdministrativeCommercialJuly 1, 2020

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - July 2020

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.

AdministrativeCommercialJuly 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

AdministrativeCommercialJuly 1, 2020

Welcome to the Custom Learning Center in Availity

AdministrativeCommercialJuly 1, 2020

Important change to prior authorization requests for inpatient hospital admissions*

Policy Updates

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2020

New MCG 24th Edition Guidelines

Products & Programs

Products & ProgramsCommercialJuly 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

Federal Employee Program (FEP)CommercialJuly 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

PharmacyCommercialJuly 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - July 2020*

PharmacyCommercialJuly 1, 2020

Updated coverage for HIV PrEP medications

State & Federal

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2020

Medicaid News - July 2020

View these Medicaid articles:
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Modifier use reminders
- Medical policies and clinical utilization management guidelines update
- New behavioral health discharge call-in line