Wisconsin
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

2019 Medicare Advantage individual benefits and formularies

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

2020 affirmative statement concerning utilization management decisions

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

2020 Medicare risk adjustment provider trainings

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

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Wisconsin Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

April 2020 Anthem Provider News - Wisconsin Medicare Apr 1, 2020

2020 Medicare risk adjustment provider trainings

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

2020 Special Needs Plans

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

2021 Medicare Advantage individual benefits and formularies

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

2022 Medicare Advantage service area and benefit updates

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

2023 Medicare Advantage service area and benefit updates

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

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Wisconsin Medicare Mar 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

AIM Specialty Health programs may require documentation

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

AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.

February 2023 Anthem Provider News - Wisconsin Medicare Feb 1, 2023

Annual planned visits

March 2023 Anthem Provider News - Wisconsin Medicare Mar 1, 2023

Annual wellness visits for Medicare Advantage members

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

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Wisconsin Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

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

Anthem expands specialty pharmacy precertification list

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

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Anthem offering Advance Medical Directives program for 2022

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

Anthem offers risk adjustment and documentation training

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

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

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

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

August 2019 Medical drug benefit Clinical Criteria updates

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

Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare Advantage

April 2023 Provider News - Wisconsin Medicare Mar 31, 2023

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

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Provider News - Wisconsin Medicare Nov 1, 2019

Cancer Care Navigator

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

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Changes to prior authorization (PA) requirements

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

Cleveland-Cliffs offers Medicare Advantage option

January 2023 Anthem Provider News - Wisconsin Medicare Dec 30, 2022

Clinical Criteria updates

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

Clinical Criteria updates

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

Clinical criteria updates

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

Clinical criteria updates

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

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Clinical criteria updates notification - December 2020

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

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Wisconsin Medicare Nov 1, 2019

Coming soon: Electronic attachments

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

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 1, 2019

Complex discharge planning

March 2020 Anthem Provider News - Wisconsin Medicare Mar 1, 2020

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Anthem Provider News - Wisconsin Medicare Mar 1, 2023

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

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

Courtesy notification of specialty pharmacy medical step therapy updates

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

COVID-19 information from Anthem Blue Cross and Blue Shield

April 2020 Anthem Provider News - Wisconsin Medicare Apr 1, 2020

Customizations to the 23rd edition of the MCG Care Guidelines

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

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Wisconsin Medicare Jun 1, 2020

Digital transactions cut administrative tasks in half

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

Digital transactions cut administrative tasks in half

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

Does your practice offer telehealth services? Let us know!

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

Dual Eligible Special Needs (D-SNP) Plans - provider training required

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

E-visits

April 2023 Provider News - Wisconsin Medicare Mar 31, 2023

Electric Boat offers Medicare Advantage options

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

Electronic claim payment reconsideration

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

Electronic data interchange process

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

Enhancing claims attachment processes through digital applications

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

Evaluation and management documentation guidelines

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

Evaluation and management services correct coding reminder (professional)

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

Evaluation and management services for COVID testing - professional

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

FDA approvals and expedited pathways used - new molecular entities

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

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

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Get faster payments with EFT

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

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

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

Good news: Non-payment remittance advice enhancements are here

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

Healthcare Quality Patient Assessment Form and Patient Assessment Form

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

HEDIS 2022: summary of changes from NCQA

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

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

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

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

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

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News - Wisconsin Medicare Jul 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

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

Important update on Botox® for Anthem Medicare members

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

In-Office Assessment program

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

In-Office Assessment Program

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

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

Information about 2021 Special Needs Plans

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

Informational Update Modifier Usage

March 2023 Anthem Provider News - Wisconsin Medicare Mar 1, 2023

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Introducing ConcertoHealth

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

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Wisconsin Medicare Oct 1, 2019

Keep up with Medicare news

October 2018 Anthem Wisconsin Provider Newsletter Medicare Sep 28, 2018

Keep up with Medicare news

February 2019 Anthem Wisconsin Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

January 2019 Anthem Wisconsin Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

December 2018 Anthem Wisconsin Provider Newsletter Medicare Dec 1, 2018

Keep up with Medicare news

March 2019 Anthem Provider Newsletter - Wisconsin Medicare Mar 1, 2019

Keep up with Medicare news - April 2019

April 2019 Anthem Provider Newsletter - Wisconsin Medicare Apr 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 - April 2023

- Clinical Criteria Updates
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Imjudo, Pedmark, Tecvayli, Tzield, Vegzelma)
- Blue Cross and Blue Shield expands specialty pharmacy precertification list (Elahere)
- New specialty pharmacy medical step therapy requirements (Avastin, Byooviz, Cimerli, Eylea, Lucentis, Vabysmo)
- Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)
- Clinical Criteria updates
April 2023 Provider News - Wisconsin Medicare Mar 31, 2023

Keep up with Medicare News - August 2022

- Upgraded data management system launches August 2022
August 2022 Anthem Provider News - Wisconsin Medicare Aug 1, 2022

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

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

Keep up with Medicare News - February 2022

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

Keep up with Medicare News - February 2023

- Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines
- Introducing the Provider Learning Hub
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Fylnetra)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Spevigo, Xenpozyme)
- Specialty pharmacy precertification list expansion (Rolvedon, Stimufend)
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirement changes effective April 1, 2023
- Medical Policies and Clinical Utilization Management Guidelines update
February 2023 Anthem Provider News - Wisconsin Medicare Feb 1, 2023

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

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
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