Wisconsin
Provider Communications

Articles Category: State & Federal / Medicaid

Title Publication Category Date

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

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
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