Wisconsin
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

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

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

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

Medicaid News - April 2021

View these Medicaid articles:
- There is something new happening at Anthem Blue Cross and Blue Shield
- Iron infusion medical step therapy notice
- November 2020 medical policies and utilization management guidelines update
- Prior authorization updates for specialty pharmacy drugs effective April 2021
- Prior authorization required for specialty pharmacy drugs effective May 2021
- Clinical criteria updates notification - November 2020
- Clinical criteria updates notification - December 2020
April 2021 Anthem Provider News - Wisconsin Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

MCG Care Guidelines 24th edition customization

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Updated AIM Rehabilitative program effective August 1, 2021 - Site of Care reviews

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Medicaid News - February 2021

View these Medicaid articles:
- Delay of AIM Musculoskeletal Program guideline updates for Medicaid
- New specialty pharmacy medical step therapy requirements
- Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326
February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

CAHPS® survey

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

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
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