CommercialJune 1, 2021

June 2021 Anthem Provider News - Wisconsin

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 4, 2021

RETRACTION: AIM Rehabilitative program - initial evaluations and site of service reviews

Medical Policy & Clinical GuidelinesCommercialJune 1, 2021

Medical policy and clinical guideline updates - June 2021*
*Material Adverse Change and/or Prior Authorization Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJune 1, 2021

Prior authorization for genetic testing medical policy effective September 1, 2021*
*Material Adverse Change and/or Prior Authorization Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJune 1, 2021

Updates to AIM advanced imaging clinical appropriateness guidelines*
*Material Adverse Change and/or Prior Authorization Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJune 1, 2021

Updates to AIM musculoskeletal program clinical appropriateness guidelines*
*Material Adverse Change and/or Prior Authorization Change (MAC)

Reimbursement PoliciesCommercialJune 1, 2021

Update to evaluation and management services correct coding - Professional

Reimbursement PoliciesCommercialJune 1, 2021

Reimbursement policy update: Outpatient facility claim edits

Products & Programs

Products & ProgramsCommercialJune 1, 2021

Let’s vaccinate

Federal Employee Program (FEP)CommercialJune 1, 2021

DEXA bone scan criteria for the Federal Employee Program®

PharmacyCommercialJune 1, 2021

Designated specialty pharmacy network updates

PharmacyCommercialJune 1, 2021

Updates for specialty pharmacy are available - June 2021*
*Material Adverse Change and/or Prior Authorization Change (MAC)

PharmacyCommercialJune 1, 2021

Pharmacy information available at anthem.com

State & Federal

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Medicaid News - June 2021
View these Medicaid articles:
- Medical drug benefit Clinical Criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Provider education program survey: Your Voice Counts

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

MCG Care Guidelines 25th Edition

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Keeping up with routine vaccination during COVID-19

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Aspire Health for members in need of palliative care

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Complex case management program

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Important information about utilization management

State & FederalBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2021

Members’ Rights and Responsibilities Statement

State & FederalMedicare AdvantageJune 1, 2021

Medicare News - June 2021
View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines

State & FederalMedicare AdvantageJune 1, 2021

Medical policies and clinical utilization management guidelines update

State & FederalMedicare AdvantageJune 1, 2021

Reimbursement policy reminder: Inpatient readmissions