Wisconsin
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

Keep up with Medicare News - May 2022

- Anthem expands specialty pharmacy precertification list-March 2022 update
- Anthem expands specialty pharmacy precertification list-April 2022 update
- New specialty pharmacy medical step therapy requirements-May 2022 update
May 2022 Anthem Provider News - Wisconsin Medicare May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

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

HEDIS 2022: summary of changes from NCQA

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

New specialty pharmacy medical step therapy requirements-March 2022 update

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

The Anthem, Inc. name is changing

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

Keep up with Medicare News - April 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Anthem expands specialty pharmacy precertification list
April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

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

Reimbursement policy update: Inpatient readmissions

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

The impact of listening

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

Clinical Criteria updates

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

Evaluation and management documentation guidelines

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

Model of Care required training

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

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date. Read important information about this change here.
Transition to NYC Medicare Advantage Plus Delayed - Wisconsin Medicare Mar 15, 2022

Keep up with Medicare News - March 2022

- Medical step therapy updates
- Phone number change for AIM in Wisconsin
March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Annual wellness visits for Medicare Advantage members

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

Pharmacy: Medication adherence

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

Evaluation and management services correct coding reminder (professional)

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

Clinical criteria updates

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

Provider notification for utilization management authorization rule operations workgroup item 2662

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

Keep up with Medicare News - February 2022

- NYC Medicare Advantage Plus update
February 2022 Anthem Provider News - Wisconsin Medicare Feb 1, 2022

School District of West Allis West Milwaukee offers Medicare Advantage option to retirees

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

Get faster payments with EFT

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

Submitting prior authorizations is getting easier

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

Keep up with Medicare News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
- Medical step therapy updates
- Anthem expands specialty pharmacy precertification list
January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Important update on Botox® for Anthem Medicare members

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

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

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

2022 Medicare Advantage service area and benefit updates

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

Keep up with Medicare News - December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

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

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

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

Reimbursement policy update: Drug screen testing

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

Good news: Non-payment remittance advice enhancements are here

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

Somatus is your resource for kidney care management

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

Keep up with Medicare News - November 2021

View these Medicare articles:
- Anthem expands specialty pharmacy prior authorization list
November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Anthem offering Advance Medical Directives program for 2022

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

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

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

New York City Medicare Advantage announcement

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

Clinical criteria updates

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

Electronic data interchange process

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

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 2021

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

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

Keep up with Medicare news - October 2021

View these Medicare articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

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

Information about 2021 Special Needs Plans

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

HEDIS medical record submission made easier with our Remote EMR Access Service

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

New medical step therapy requirements

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

Keep up with Medicare news - September 2021

View this Medicare article:
- Clinical criteria updates notification – May 2021

 

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Prior authorization form notification

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Medicare News - August 2021

View these Medicare articles:
- Infliximab Step Therapy - Effective 7/15/2021
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907
August 2021 Anthem Provider News - Wisconsin Medicare Aug 1, 2021

Preventing claims denials: Shingles vaccine

August 2021 Anthem Provider News - Wisconsin Medicare Aug 1, 2021

Medicare News - July 2021

View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Let’s Vaccinate

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

Medical drug benefit clinical criteria updates

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

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

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

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

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

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

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

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

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

Reimbursement policy reminder: Inpatient readmissions

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

Maximizing efficient, high quality COVID-19 screenings

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

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal Program clinical appropriateness guidelines
May 2021 Anthem Provider News - Wisconsin Medicare May 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Clinical criteria updates notification - November 2020

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Clinical criteria updates notification - December 2020

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Wisconsin Medicare Mar 1, 2021

New provider directory indicator for telehealth services

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

Medical policies and clinical utilization management guidelines update

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

Access to more claim denial information is now self-service

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

PN for UM AROW Item 1330

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

Medical drug benefit clinical criteria updates - February 2021

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

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
- Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines
January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

2020 Medicare risk adjustment provider trainings

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

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

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

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

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

Medical drug benefit clinical criteria updates

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

Transition to AIM small joint guidelines

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

2021 Medicare Advantage individual benefits and formularies

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

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

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

Medical policies and clinical utilization management guidelines update

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

Policy Update: Emergency Department: Leveling of Evaluation and Management Services

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

Digital transactions cut administrative tasks in half

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

Medicare News - November 2020

View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed
November 2020 Anthem Provider News - Wisconsin Medicare Nov 1, 2020

Provider Chat: A fast, easy way to get your questions answered

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

Digital transactions cut administrative tasks in half

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

FDA approvals and expedited pathways used - new molecular entities

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

Medicare News - October 2020

View these Medicare articles:
- Evaluation and management services correct coding
- Medical policies and clinical utilization management guidelines update
- Prior authorization requirements for the below codes effective January 2021
October 2020 Anthem Provider News - Wisconsin Medicare Oct 1, 2020

Medical drug benefit clinical criteria updates

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

Prior authorization requirements for the below codes effective January 1, 2021

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

Social determinants of health support expanding with GroundGame Health

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

Provider transparency update

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

Update: Notice of changes to the AIM musculoskeletal program

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

Medical drug benefit clinical criteria updates

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

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Wisconsin Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

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

2020 Medicare risk adjustment provider trainings

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