Wisconsin
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

Medicaid News - January 2021

View these Medicaid articles:
- August 2020 Medical Policies and Utilization Management Guidelines update
- Independent laboratory provider – Place of service 81
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirements for Moderate to Deep Anesthesia for Dental Surgery in the Facility Setting
- Policy Update: Nurse Practitioner and Physician Assistant Services
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
- Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines
January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

FDA approvals and expedited pathways used - new molecular entities (NMEs)

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Disease Management/Population Health program

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Coding spotlight: HEDIS MY 2021

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Medicaid News - December 2020

View these Medicaid article:
- Anti-VEGF Medical Step Therapy Notice
- Important reminder: Coding requirements for reimbursement for early elective deliveries
- Transition to AIM small joint guidelines

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

CAHPS education for providers

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Notifications on the Availity Portal

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Resources to support your pregnant and postpartum patients and their families

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Sign up to receive email from Anthem Blue Cross and Blue Shield

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 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
November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Medical drug benefit clinical criteria updates

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Prior authorization requirements for HCPCS code 55899

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Inhaled nitric oxide reviews for diagnosis-related group admissions

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Provider transparency update

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Coding spotlight: Tips and best practices for compliance

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

Prior authorization requirements for E0482

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

Coding spotlight: Providers guide to coding for behavioral health disorders

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Wisconsin Medicaid Sep 1, 2020

Medical policies and clinical utilization management guidelines update

September 2020 Anthem Provider News - Wisconsin Medicaid Sep 1, 2020

What Matters Most online training course: Improving patient experience

September 2020 Anthem Provider News - Wisconsin Medicaid Sep 1, 2020

Medicaid News - August 2020

View this Medicaid article:
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

New MCG Care Guidelines 24th edition

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Provider data update

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Controlling high blood pressure (CBP)

August 2020 Anthem Provider News - Wisconsin Medicaid Aug 1, 2020

Medicaid News - July 2020

View these Medicaid articles:
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Modifier use reminders
- Medical policies and clinical utilization management guidelines update
- New behavioral health discharge call-in line
July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Submit behavioral health authorizations via our online Interactive Care Reviewer tool

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to coding for cardiovascular conditions

July 2020 Anthem Provider News - Wisconsin Medicaid Jul 1, 2020

Medicaid News - June 2020

View these Medicaid articles:
- Resources supporting our providers during COVID-19
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
- November 2019 Medical Policies and Clinical Utilization Management Guidelines update
June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Coding spotlight - provider’s guide to code social determinants of health

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

2020 affirmative statement concerning utilization management decisions

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Complex Case Management program

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Important information about utilization management

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Member Rights’ and Responsibilities Statement

June 2020 Anthem Provider News - Wisconsin Medicaid Jun 1, 2020

Reimbursement Policy Update Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Wisconsin Medicaid May 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Medicaid News - April 2020

View these Medicaid notices:
- November 2019 Medical Policies and Clinical Utilization Management Guidelines update
- Personal care prior authorization
- Prior authorization requirements for A6550 and A9278
April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Prior authorization requirements: new 2020 codes for coverage and precertification

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Medical drug benefit Clinical Criteria updates - December 2019

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Disease Management can help you care for patients with chronic health care needs

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Use of Imaging Studies for Low Back Pain (LBP)

April 2020 Anthem Provider News - Wisconsin Medicaid Apr 1, 2020

Reminder: Mid-level practitioners are required to file using their NPI

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Coding tip for psychological and neuropsychological testing

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Antibiotic dispensing guidelines

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Coding spotlight: HIV and AIDS

March 2020 Anthem Provider News - Wisconsin Medicaid Mar 1, 2020

Medicaid News - February 2020

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

Postponed - Review of professional claims with emergency room level 5 E/M codes

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

Resources to support your diverse patient panel

February 2020 Anthem Provider News - Wisconsin Medicaid Feb 1, 2020

Medicaid News -- January 2020

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

August 2019 medical drug benefit clinical criteria updates

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

September 2019 medical drug benefit clinical criteria updates

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Verifying and updating your provider information

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Coding spotlight: provider’s guide to coding respiratory diseases

January 2020 Anthem Provider News - Wisconsin Medicaid Jan 1, 2020

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Coding spotlight: provider’s guide to coding behavioral and emotional disorders

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Reimbursement Policy Update: Multiple and Bilateral Surgery, Professional and Facility Reimbursement

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

Global 3M19 Medical Policy and Technology Assessment Committee prior authorization requirement updates

December 2019 Anthem Provider News - Wisconsin Medicaid Dec 1, 2019

New Reimbursement Policy: Update Drug Screen Testing

November 2019 Anthem Provider News - Wisconsin Medicaid Nov 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Provider News - Wisconsin Medicaid Nov 1, 2019

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

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

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

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

Medicaid News -- June 2019

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

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

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
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