CommercialJuly 1, 2021
July 2021 Anthem Provider News - Wisconsin
Administrative
CommercialJuly 1, 2021
Register now to learn strategies to help you and your practice improve clinical qualityCommercialJuly 1, 2021
Another mark of the pandemic: An increase in childhood obesityCommercialJuly 1, 2021
Proper coding for in-home monitoring can make a measurable difference for INRCommercialJuly 1, 2021
Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claimsCommercialJuly 1, 2021
Interactive Care Reviewer (ICR): New search option for cases submitted through ICRCommercialJuly 1, 2021
Electronic claim response filesCommercialJuly 1, 2021
How to enroll in electronic fund transfer (EFT) for faster remittancePolicy Updates
CommercialJuly 1, 2021
Medical Policy and Clinical Guideline Updates - July 2021*CommercialJuly 1, 2021
Reimbursement policy update: Consultations - Professional*Products & Programs
CommercialJuly 1, 2021
Certain specialty medication prior authorization requests may require additional documentation*CommercialJuly 1, 2021
Updates for specialty pharmacy are available - July 2021*CommercialJuly 1, 2021
Designated specialty pharmacy network updates effective October 1, 2021*CommercialJuly 1, 2021
Update: Site of care medical necessity reviews for long-acting colony-stimulating factors not implemented on June 1, 2021*State & Federal
BadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patientsMedicare AdvantageJuly 1, 2021
New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billingMedicare AdvantageJuly 1, 2021
Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021Medicare AdvantageJuly 1, 2021
Medical drug benefit clinical criteria updatesMedicare AdvantageJuly 1, 2021
Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patientsMedicare AdvantageJuly 1, 2021
Let’s VaccinateMedicare AdvantageJuly 1, 2021
Medicare News - July 2021- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
BadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billingBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Updates to AIM Specialty Health Musculoskeletal Program clinical appropriateness guidelinesBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Prior authorization requirement changes effective September 1, 2021BadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Prior authorization requirement changes effective September 1, 2021 - UM AROW 1837BadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
March 2021 medical drug benefit clinical criteria updatesBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Coding spotlight: Mental disorders in childhoodBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Resources to support your diverse patient panelBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
What Matters Most: Improving the patient experienceBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Let’s VaccinateBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2021
Medicaid News - July 2021- Specialty pharmacy prior authorization retraction notice
- Infusion step therapy retraction notice
- Specialty Rx precertification additional documentation notice effective August 1, 2021
- Prior authorization requirement changes effective September 1, 2021–UM AROW 1327
- February 2021 medical policies and utilization management guidelines update
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