CommercialMay 1, 2021

May 2021 Anthem Provider News - Wisconsin

Administrative

AdministrativeCommercialMay 1, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 2021
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.

AdministrativeCommercialMay 1, 2021

Updated 2021 Provider Manual now available

AdministrativeCommercialMay 1, 2021

Resources to support diverse patients and communities

AdministrativeCommercialMay 1, 2021

A helpful and complete guide to covered well-child visits

AdministrativeCommercialMay 1, 2021

May is National High Blood Pressure Education Month

AdministrativeCommercialMay 1, 2021

Sending larger digital attachments through Availity

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 1, 2021

New prior authorization requirement: Kidney transplantation*
*Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialMay 1, 2021

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

Reimbursement PoliciesCommercialMay 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*
*Material Adverse Change (MAC)

Reimbursement PoliciesCommercialMay 1, 2021

Reimbursement policy reminder: Readmission - Facility

Reimbursement PoliciesCommercialMay 1, 2021

Reimbursement policy update: Frequency editing - Professional

Products & Programs

PharmacyCommercialMay 1, 2021

Updates for specialty pharmacy are available - May 2021*
*Material Adverse Change (MAC)

State & Federal

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

Medicaid news - May 2021
View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Updates to the AIM Specialty Health Musculoskeletal Program Clinical Appropriateness Guidelines

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

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

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

Reimbursement policy update: Multiple and bilateral surgery - Professional and Facility

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

Continuing medical education and continuing education unit opportunities

State & FederalBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2021

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State & FederalMedicare AdvantageMay 1, 2021

Keep up with Medicare news - May 2021
View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal Program clinical appropriateness guidelines

State & FederalMedicare AdvantageMay 1, 2021

Maximizing efficient, high quality COVID-19 screenings