Wisconsin
Provider Communications

Articles

Title Publication Category Date

Do you offer telehealth services? Let us know!

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

Enhancing Provider News website and email communications

February 2023 Anthem Provider News - Wisconsin Digital Tools Feb 1, 2023

Medical Policies and Clinical Guidelines updates - February 2023*

*Material adverse change (MAC)

February 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2023

Have you reviewed your online provider directory information lately?

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

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update*

*Material adverse change (MAC)

February 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2023

Specialty pharmacy updates - February 2023*

*Material adverse change (MAC)

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

Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements

February 2023 Anthem Provider News - Wisconsin Digital Tools Feb 1, 2023

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

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

Keep up with Medicaid News - February 2023

- Prior authorization updates for medications billed under the medical benefit (Enjaymo, Kimmtrak, Tezspire, Voxzogo)
- Prior authorization updates for medications billed under the medical benefit (Pluvicto, Opdualag, Alymsys, Yusimry)
- Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines
- Introducing the Provider Learning Hub
February 2023 Anthem Provider News - Wisconsin Medicaid Feb 1, 2023

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

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

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

Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023

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

2023 FEP benefit information available online

February 2023 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Feb 1, 2023

Important reminder: New ID cards for many of our Anthem Blue Cross and Blue Shield members

New ID cards for Anthem Blue Cross and Blue Shield members - Wisconsin Administrative Jan 19, 2023

Telephonic-only care allowance extended through April 11, 2023

Telephonic-only care allowance extended through April 11, 2023 - Wisconsin Administrative Jan 11, 2023

Notification regarding reimbursement changes to COVID-19 laboratory services codes*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

Engagement with your patient counts

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

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines *

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Specialty pharmacy updates*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Pharmacy Dec 30, 2022

Attention physicians and lab providers: COVID-19 update regarding reimbursement

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

Childhood Immunization Status and Lead Screening in Children for HEDIS

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

Monkeypox and smallpox vaccines: Product code on claims

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

Keep up with Medicaid News - January 2023

- This is Quitting: Helping teens and young adults quit vaping
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
January 2023 Anthem Provider News - Wisconsin Medicaid Dec 30, 2022

Keep up with Medicare news - January 2023

- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
January 2023 Anthem Provider News - Wisconsin Medicare Dec 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Dec 30, 2022

Cleveland-Cliffs offers Medicare Advantage option

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

Submitting prior authorizations digitally through Interactive Care Reviewer

January 2023 Anthem Provider News - Wisconsin Digital Tools Dec 30, 2022

Outpatient facility revenue code billing requirements

January 2023 Anthem Provider News - Wisconsin Reimbursement Policies Dec 30, 2022

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Professional system updates for 2023

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

Outpatient system updates for 2023

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

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

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

Childhood Immunization Status and Lead Screening in Children for HEDIS

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

Attention lab providers: COVID-19 update regarding reimbursement*

*Material Adverse Change (MAC)
December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Coordination of care

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

Case management program

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

Important information about utilization management

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

IngenioRx will become CarelonRx on January 1, 2023

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

Specialty pharmacy updates - December 2022*

*Material adverse change (MAC)
December 2022 Anthem Provider News - Wisconsin Pharmacy Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Medical Policies and Clinical Guidelines updates - December 2022*

*Material adverse change (MAC)
December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Keep up with Medicaid News - December 2022

- Prior authorization requirement changes effective January 1, 2023
- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
- Prior authorization updates for medications billed under the medical benefit (Releuko, Vabysmo)
- Signature requirements for laboratory orders or requisitions
December 2022 Anthem Provider News - Wisconsin Medicaid 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

2023 Medicare Advantage service area and benefit updates

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

Member assessment of PCP after-hours messaging in 2022

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

Member’s assessment of behavioral healthcare after-hours messaging in 2022

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

Members’ rights and responsibilities

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

CAA: Timely updates help keep our provider directories current

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

Clinical practice and preventive health guidelines available on anthem.com

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

Signature requirements for laboratory orders or requisitions

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

Pharmacy information available on the provider website

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

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Personal home helper benefit ending

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

PCP searches in Find Care

PCP searches in Find Care - Wisconsin Administrative Nov 2, 2022

Claims status message enhancements: providing clear descriptions and actionable next steps

November 2022 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2022

Submit digital attachments within seven-calendar days for claims filed with a PWK segment indicator

November 2022 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2022

You can now submit one electronic claim dispute for multiple claims and access correspondence digitally, too

November 2022 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2022

Visit the Provider Learning Hub to view our latest learning opportunities

November 2022 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2022

Remote EMR access service for HEDIS

November 2022 Anthem Provider News - Wisconsin Digital Tools Nov 1, 2022

Specialty pharmacy updates - November 2022

Material Adverse Change (MAC)

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

Medical policy and clinical guideline updates - November 2022

Material Adverse Change (MAC)
November 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2022

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

November 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2022

Correction to reimbursement policy: Place of Service - Facility

Material Adverse Change (MAC)

November 2022 Anthem Provider News - Wisconsin Reimbursement Policies Nov 1, 2022

Keep up with Medicaid News - November 2022

- Prior authorization requirement changes effective November 1, 2022
- Medical drug benefit Clinical Criteria updates
- Appointment access and geographic availability
November 2022 Anthem Provider News - Wisconsin Medicaid Nov 1, 2022

Guidance for coding evaluation and management services for new and established patients

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

Important information about utilization management

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

Policy update: Inpatient Readmissions

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

Alcohol use disorders often coexist with psychiatric disorders

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

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

Support documentation for AIM prior authorization requests

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

Personalized Match

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

CAA: Keep your provider directory information up to date

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

Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list

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

Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022

As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED.
Future updates regarding COVID-19 will appear in the monthly Provider News publication.
COVID-19 Information - Wisconsin – Publication RETIRED as of November 8, 2022 Administrative Oct 13, 2022

MCG care guidelines 26th edition update

Effective September 23, 2022, we will upgrade to the 26th edition of MCG care guidelines for the following modules: Inpatient/surgical care (ISC). 
MCG care guidelines 26th edition update - Wisconsin State & Federal Oct 12, 2022

Register for our upcoming CME webinar about low back pain management

CME webinar about low back pain management - Wisconsin Administrative Oct 7, 2022

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

National Accounts 2023 Precertification list

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

The Provider Learning Hub is here

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

Guidance for coding evaluation and management services for new and established patients RETRACTION: Please refer to article published 9/1/22

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

CAA: Review your online provider directory information

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

New Strategic Provider System implementation in August 2022

October 2022 Anthem Provider News - Wisconsin Digital Tools Oct 1, 2022

Pharmacy information available on provider website

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

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

October 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2022

Courtesy notification of specialty pharmacy medical step therapy updates

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

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

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

Learn how Interactive Care Reviewer makes it easy to submit authorizations electronically

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

Monkeypox and smallpox vaccines: Product code on claims

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

IngenioRx will become CarelonRx on January 1, 2023

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

Specialty pharmacy updates - October 2022

Material Adverse Change (MAC)
October 2022 Anthem Provider News - Wisconsin Pharmacy Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Material Adverse Change (MAC)
October 2022 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

October 2022 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2022

Keep up with Medicaid News - October 2022

- New specialty pharmacy medical step therapy requirements
- Prior authorization updates for medications billed under the medical benefit-1
- Prior authorization updates for medications billed under the medical benefit-2
- Change to claims acceptance based on Clinical Laboratory Improvement Amendments
- MCG 26th Edition update
October 2022 Anthem Provider News - Wisconsin Medicaid Oct 1, 2022
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