Wisconsin
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

Keep up with Medicaid News - November 2022

- Prior authorization requirement changes effective November 1, 2022
- Medical drug benefit Clinical Criteria updates
- Appointment access and geographic availability
November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Guidance for coding evaluation and management services for new and established patients

November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Important information about utilization management

November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Policy update: Inpatient Readmissions

November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Alcohol use disorders often coexist with psychiatric disorders

November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Keep up with Medicaid News - October 2022

- New specialty pharmacy medical step therapy requirements
- Prior authorization updates for medications billed under the medical benefit-1
- Prior authorization updates for medications billed under the medical benefit-2
- Change to claims acceptance based on Clinical Laboratory Improvement Amendments
- MCG 26th Edition update
October 2022 Anthem Provider News - Wisconsin Medicaid Oct 1, 2022

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional (WI only)

October 2022 Anthem Provider News - Wisconsin Medicaid Oct 1, 2022

Members’ Rights and Responsibilities section

October 2022 Anthem Provider News - Wisconsin Medicaid Oct 1, 2022

Monkeypox resources and recommendations for our care providers

October 2022 Anthem Provider News - Wisconsin Medicaid Oct 1, 2022

Keep up with Medicaid News - September 2022

- Clinical criteria updates
September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

New Digital Provider Enrollment tool added to Availity

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

Reimbursement policy update: Modifiers 25 and 57 - Evaluation and Management with Global Procedures

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

Enhancing claims attachment processes through digital applications

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

Complex Case Management program

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

New specialty pharmacy medical step therapy requirements

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

Alcohol use disorders linked to chronic diseases

September 2022 Anthem Provider News - Wisconsin Medicaid Sep 1, 2022

Keep up with Medicaid News - August 2022

- Specialty pharmacy site of care
- Upgraded data management system launches August 2022
August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

We are here

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

HEDIS 2022: Summary of changes from NCQA

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

Prior authorization requirement changes effective November 1, 2022

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

Chlamydia screening

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

Using SBIRT to address opioid and substance use disorders

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

The cost of alcohol use disorder

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

Cataract awareness

August 2022 Anthem Provider News - Wisconsin Medicaid Aug 1, 2022

Keep up with Medicaid News - July 2022

July 2022 Anthem Provider News - Wisconsin Medicaid Jul 1, 2022

Prior authorization requirement changes effective August 1, 2022

July 2022 Anthem Provider News - Wisconsin Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Anthem Provider News - Wisconsin Medicaid Jul 1, 2022

New Strategic Provider System will launch in August 2022

July 2022 Anthem Provider News - Wisconsin Medicaid Jul 1, 2022

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Anthem Provider News - Wisconsin Medicaid Jul 1, 2022

Keep up with Medicaid News - June 2022

- Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
- Prior authorization update for select durable medical equipment (DME) items
- Prior authorization updates for medications billed under the medical benefit
- Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
June 2022 Anthem Provider News - Wisconsin Medicaid Jun 1, 2022

Evaluation and management services for COVID testing - professional

June 2022 Anthem Provider News - Wisconsin Medicaid Jun 1, 2022

New Strategic Provider System will launch in August 2022

June 2022 Anthem Provider News - Wisconsin Medicaid Jun 1, 2022

Medical drug benefit clinical criteria updates

June 2022 Anthem Provider News - Wisconsin Medicaid Jun 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

June 2022 Anthem Provider News - Wisconsin Medicaid Jun 1, 2022

Keep up with Medicaid News - May 2022

- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Prior authorization requirement change for HCPCS code K1022
- New specialty pharmacy medical step therapy requirements-March 2022
May 2022 Anthem Provider News - Wisconsin Medicaid May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Anthem Provider News - Wisconsin Medicaid May 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Keep up with Medicaid News - April 2022

- Medical policies and clinical utilization management guidelines update
- Phone number change for AIM in Wisconsin
- Medical drug benefit clinical criteria updates
- Specialty pharmacy site of care program retraction
- Prior authorization updates for medications billed under the medical benefit
April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Reimbursement policy update: Inpatient readmissions

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Evaluation and management documentation guidelines

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

It is CAHPS survey time!

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Evaluation and management services correct coding reminder (professional)

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Keep up with Medicaid News - February 2022

- Prior authorization updates for medications billed under the medical benefit
February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Get faster payments with EFT

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

2021 CAHPS survey results

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Cancer Care Navigator

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Keep up with Medicaid News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines updates
- Specialty pharmacy site of care
- Prior authorization updates for medications billed under the medical benefit
January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

The Behavioral Health Areas of Expertise Profile improves the referral process

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Botox update for Anthem members

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Keep up with Medicaid News - December 2021

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit Clinical Criteria updates
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Medical policies and clinical utilization management guidelines update

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Prior authorization requirement changes effective December 1, 2021

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Reimbursement policy update: Drug screen testing

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Keep up with Medicaid News - November 2021

View these Medicaid articles:
- Prior authorization updates for specialty pharmacy
November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Reimbursement policy update: Corrected claims

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your female patients

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Keep up with Medicaid News - October 2021

View these Medicaid articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 medical policies and utilization management guidelines update
October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Diabetes testing and screening HEDIS measures

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Keep up with Medicaid news  - September 2021

View these Medicaid articles:
- Clinical Criteria Updates Notification – May 2021
- CT to detect coronary artery calcification — AIM transition
September 2021 Anthem Provider News - Wisconsin Medicaid Sep 1, 2021

Medicaid News - August 2021

View these Medicaid articles:
-Iron Infusion Step Therapy
-Prior authorization requirement changes effective September 1, 2021 – UM AROW 1837
-Iron Infusion Prior Authorization Update
August 2021 Anthem Provider News - Wisconsin Medicaid Aug 1, 2021

Medicaid News - July 2021

View these Medicaid articles:
- Specialty pharmacy prior authorization retraction notice
- Infusion step therapy retraction notice
- Specialty Rx precertification additional documentation notice effective August 1, 2021
- Prior authorization requirement changes effective September 1, 2021–UM AROW 1327
- February 2021 medical policies and utilization management guidelines update
July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

What Matters Most: Improving the patient experience

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Coding spotlight: Mental disorders in childhood

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

March 2021 medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021 - UM AROW 1837

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal Program clinical appropriateness guidelines

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 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
June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Complex case management program

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 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
May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

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

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

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

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

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

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Continuing medical education and continuing education unit opportunities

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021
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