CommercialNovember 1, 2020

November 2020 Anthem Provider News - Wisconsin

Administrative

AdministrativeCommercialNovember 1, 2020

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

AdministrativeCommercialNovember 1, 2020

Availity attachment tools for Anthem and affiliate payers - Live Webinars
Sign up for upcoming webinars!

AdministrativeCommercialNovember 1, 2020

Digital transactions cut administrative tasks in half

AdministrativeCommercialNovember 1, 2020

US Antibiotic Awareness Week

Policy Updates

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2020

Medical policy and clinical guideline updates - November 2020*

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2020

Correction to Prior Authorization Update for Commercial business*

Medical Policy & Clinical GuidelinesCommercialNovember 1, 2020

Reminder: Post-service reviews using AIM

Reimbursement PoliciesCommercialNovember 1, 2020

Reimbursement policy update: Modifier rules (Professional)*

Reimbursement PoliciesCommercialNovember 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

Products & Programs

State & Federal

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Medicaid News - November 2020
View these Medicaid article:
- Evaluation and management services correct coding
- New specialty pharmacy medical step therapy requirements
- Provider Chat: A fast, easy way to get your questions answered
- New specialty pharmacy medical step therapy requirements
- Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations
- Electronic visit verification notification

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Digital transactions cut administrative tasks in half

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Medical drug benefit clinical criteria updates

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Prior authorization requirements for HCPCS code 55899

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Inhaled nitric oxide reviews for diagnosis-related group admissions

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Provider transparency update

State & FederalBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2020

Coding spotlight: Tips and best practices for compliance

State & FederalMedicare AdvantageNovember 1, 2020

Medicare News - November 2020
View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed

State & FederalMedicare AdvantageNovember 1, 2020

Provider Chat: A fast, easy way to get your questions answered

State & FederalMedicare AdvantageNovember 1, 2020

Digital transactions cut administrative tasks in half

State & FederalMedicare AdvantageNovember 1, 2020

FDA approvals and expedited pathways used - new molecular entities