Wisconsin
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

Submitting prior authorizations is getting easier

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

Keep up with Medicare News - June 2022

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

Evaluation and management services for COVID testing - professional

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

Authorizations for post-acute care services for Medicare Advantage individual, Group Retiree Solutions (GRS), and Dual-Eligible Plan members

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

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

Medical drug benefit clinical criteria updates

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

Medical policies and clinical utilization management guidelines update

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

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

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

Keep up with Medicare News - March 2023

- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines - Material adverse change (MAC)
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Neulasta, Neulasta OnPro, Udenyca)
March 2023 Anthem Provider News - Wisconsin Medicare Mar 1, 2023

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

2023 Medicare Advantage service area and benefit updates

December 2022 Anthem Provider News - Wisconsin Medicare Dec 1, 2022

Keep up with Medicare News - December 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- Signature requirements for laboratory orders or requisitions
December 2022 Anthem Provider News - Wisconsin Medicare Dec 1, 2022

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Anthem transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Please evaluate statin use for MA members with diabetes, cardiovascular disease

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Medicare pharmacy and prescriber home starts January 2019

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Keep up with Medicare news

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Keep up with Medicare News - November 2022

- Medical drug benefit Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
- New specialty pharmacy medical step therapy requirements (Zarxio)
November 2022 Anthem Provider News - Wisconsin Medicare Nov 1, 2022

Outpatient Rehabilitation Program transitioning to AIM

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

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

The Anthem, Inc. name is changing

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

Sepsis diagnosis coding and billing reminder

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Electronic claim payment reconsideration

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

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

Keep up with Medicare News -- July 2019

July 2019 Anthem Provider News - Wisconsin Medicare Jul 1, 2019

Medicare News -- September 2019

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

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

Coming soon: Electronic attachments

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Reimbursement policy update: Inpatient readmissions

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

Clinical Criteria updates

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

The impact of listening

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

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

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

Clinical Criteria updates

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

Changes to prior authorization (PA) requirements

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Evaluation and management documentation guidelines

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

Pharmacy benefit manager change to IngenioRx

September 2019 Anthem Provider News - Wisconsin Medicare Sep 1, 2019

Model of Care required training

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

2022 Medicare Advantage service area and benefit updates

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

Medicare News -- August 2019

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Reimbursement policy update: Drug screen testing

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

New service types added to Availity

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

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

New Reimbursement Policy: Drug Screen Testing

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Somatus is your resource for kidney care management

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

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

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

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

Special needs plans - provider training required

August 2019 Anthem Provider News - Wisconsin Medicare Aug 1, 2019

Medicare News -- January 2020

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

2021 Medicare Advantage individual benefits and formularies

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

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

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

Does your practice offer telehealth services? Let us know!

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

Introducing ConcertoHealth

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

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

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

Medicare preferred continuous glucose monitors

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

August 2019 Medical drug benefit Clinical Criteria updates

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

September 2019 Medical drug benefit Clinical Criteria updates

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

In-Office Assessment program

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

Help protect your patients by providing medical ID protection - best practices

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

Medicare News - July 2020

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

Medical policies and clinical utilization management guidelines update

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

Oncology dose reduction program beginning July 1, 2021

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

Reminder: Medicare claims for secondary payer must be submitted after the 30-day Medicare remittance period

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

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

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

Clinical criteria updates notification - November 2020

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

Healthcare Quality Patient Assessment Form and Patient Assessment Form

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

2020 affirmative statement concerning utilization management decisions

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

Clinical criteria updates notification - December 2020

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

Electric Boat offers Medicare Advantage options

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

Medical drug benefit clinical criteria updates

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

2020 Medicare risk adjustment provider trainings

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

In-Office Assessment Program

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

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

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

2020 Special Needs Plans

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

Digital transactions cut administrative tasks in half

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

Medical Policies and Clinical Utilization Management Guidelines Update-Wisconsin

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

Verifying and updating your provider information

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

Transition to AIM small joint guidelines

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

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

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 2022

- Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
- Anthem expands specialty pharmacy precertification list-1
- Anthem expands specialty pharmacy precertification list-2
- Consultation codes
- MCG 26th Edition update
October 2022 Anthem Provider News - Wisconsin Medicare Oct 1, 2022

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

Keep up with Medicare News - July 2022

- New specialty pharmacy medical step therapy requirements
July 2022 Anthem Provider News - Wisconsin Medicare 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 Medicare Jul 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

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

Cancer Care Navigator

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

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

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

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Wisconsin Medicare May 1, 2020

New Strategic Provider System will launch in August 2022

July 2022 Anthem Provider News - Wisconsin Medicare Jul 1, 2022
Page 1 of 3 Next Page