Wisconsin
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

New pregnancy notification process using the Availity Portal Benefit Look-Up Tool

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

March 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Authorization process update for identified HCBS procedure codes

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

New clinical guideline: pneumatic compression devices, effective December 1, 2019

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Reimbursement Policy Update: Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

MCG Care Guidelines update and customizations

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicaid Oct 1, 2019

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review*

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

Pre-certification information for the Federal Employee Program*

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2019

Medicare News -- October 2019

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Medicare preferred continuous glucose monitors

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Prior authorization requirements changes effective November 1, 2019

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Medicare News -- September 2019

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Coming soon: Electronic attachments

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Changes to prior authorization (PA) requirements

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Coming soon: electronic attachments

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Prior authorization changes

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Update: E&M with Modifier 25 same day as procedure when a prior E&M for the same or similar service has occurred (Professional)

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Medical drug Clinical Criteria updates

September 2019 Anthem Provider News - Wisconsin Medicaid Sep 1, 2019

Medicaid News -- August 2019

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Pharmacy management information

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Use the Provider Maintenance Form for professional providers to update your information

August 2019 Anthem Provider News - Wisconsin Medicaid Aug 1, 2019

Medicare News -- August 2019

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

New service types added to Availity

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Special needs plans - provider training required

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Electronic claim payment reconsideration

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Anthem Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

July 2019 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jul 1, 2019

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Electronic claim payment reconsideration

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Keep up with Medicare News -- July 2019

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

New service types added to Availity

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Coding Spotlight: Hypertension

July 2019 Anthem Provider News - Wisconsin Medicaid Jul 1, 2019

Keep up with Medicare News -- June 2019

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Anthem Provider Newsletter - Wisconsin Medicare Jun 1, 2019

Medicaid News -- June 2019

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Complex Case Management program

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Important information about utilization management

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Members' Rights and Responsibilities Statement

June 2019 Anthem Provider Newsletter - Wisconsin Medicaid Jun 1, 2019

Medicaid News - May 2019

May 2019 Anthem Provider Newsletter - Wisconsin Medicaid May 1, 2019

Clinical Criteria updates - May 2019

May 2019 Anthem Provider Newsletter - Wisconsin Medicaid May 1, 2019

Keep up with Medicare news - May 2019

May 2019 Anthem Provider Newsletter - Wisconsin Medicare May 1, 2019

Update regarding evaluation and management with modifier 25

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 1, 2019

Keep up with Medicare news - April 2019

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 1, 2019

Provider surveys

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

November 2018 Medical Policies and Clinical Utilization Management Guidelines update

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Clinical Criteria updates

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Help prevent preeclampsia with prenatal aspirin

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Practitioners’ rights during credentialing process

April 2019 Anthem Provider Newsletter - Wisconsin Medicaid Apr 1, 2019

Dual Eligible Special Needs (D-SNP) Plans - provider training required

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Keep up with Medicare news

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Coding Spotlight: Cancer - a provider’s guide to properly code cancers

March 2019 Anthem Provider Newsletter - Wisconsin Medicaid Mar 1, 2019

Neonatal intensive care unit post-traumatic stress disorder program

March 2019 Anthem Provider Newsletter - Wisconsin Medicaid Mar 1, 2019

Coding spotlight: Diabetes - provider guide to coding the diagnosis and treatment of diabetes

February 2019 Anthem Wisconsin Provider Newsletter Medicaid Feb 1, 2019

Introducing a new clinical criteria webpage for injectable, infused or implanted drugs covered under the medical benefit

February 2019 Anthem Wisconsin Provider Newsletter Medicaid Feb 1, 2019

HEDIS 2019 Federal Employee Program® medical record request requirements

February 2019 Anthem Wisconsin Provider Newsletter Federal Employee Plan (FEP) Feb 1, 2019

Reminder: Anthem follows Original Medicare policies

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

New specialty Medicare Part B device preferred product program

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Anthem offers risk adjustment and documentation training

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Transition of Outpatient Rehabilitation Utilization Management program

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

My Diverse Patients - a website to support your diverse patients

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update: January 2019

January 2019 Anthem Wisconsin Provider Newsletter Medicaid Jan 1, 2019

Electronic data interchange (EDI) gateway update

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

NCQA: Pharmacy Management Information

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

NCQA: Practitioners’ Rights during Credentialing Process

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Coding Spotlight: Substance Use Disorders and Smoking

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Medical Policies and Clinical Utilization Management Guidelines Update-Wisconsin

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

UPDATE: Prior Authorization Requirements for High-Level, Definitive Drug Testing Delayed

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Prior Authorization Requirements for Sublocade

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018

Reimbursement Policy Update: Claims Requiring Additional Documentation

December 2018 Anthem Wisconsin Provider Newsletter Medicaid Dec 1, 2018
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