Wisconsin
Provider Communications

Articles

Title Publication Category Date

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

May 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

*Material Adverse Change (MAC)
May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 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

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Wisconsin Medicare 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

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

Updates for specialty pharmacy are available - April 2021*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Pharmacy Apr 1, 2021

Pharmacy information available at anthem.com

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

Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021

Does your practice offer telehealth services? Let us know!

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

Information Center - Access important policies, forms and helpful resources

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

Understanding Availity roles for electronic data interchange (EDI)

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

Make the change to digital authorization/referral and hospital admission notifications using EDI

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

Attention facilities: Sending admission, discharge and transfer data results in improved care management for patients

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

Chat directly with a prior authorization specialist

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

Keeping up with routine vaccination during COVID-19

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

Interactive bilingual website taking action for our health

Exclusively developed for the Latino Community
April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021

Join Anthem in talking about racism and its impact on health

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

Medical policy and clinical guideline updates - April 2021*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Update: Clinical guideline adoption postponed*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

MCG Care Guidelines 25th Edition available*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNFs)

April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Maximizing efficient, high quality COVID-19 screenings*

*Material Adverse Change (MAC)
COVID-19 Information - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Apr 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

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - April 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
April 2021 Anthem Provider News - Wisconsin Administrative Apr 1, 2021

The health of millennials: Trends in behavioral health conditions

April 2021 Anthem Provider News - Wisconsin Behavioral Health Apr 1, 2021

Designated specialty pharmacy network*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Pharmacy Apr 1, 2021

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - March 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
March 2021 Anthem Provider News - Wisconsin Administrative Mar 1, 2021

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Wisconsin Pharmacy Mar 1, 2021

Updates for specialty pharmacy are available - March 2021*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Wisconsin Pharmacy Mar 1, 2021

Some HIV medication combinations may require prior authorization

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

Medical attachment capability now includes itemized bills and more!

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

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Mar 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

March 2021 Anthem Provider News - Wisconsin Reimbursement Policies Mar 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

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

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - February 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
February 2021 Anthem Provider News - Wisconsin Administrative Feb 1, 2021

Anthem to update formulary lists for commercial health plan pharmacy benefit

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

Prior authorization updates for specialty pharmacy are available - February 2021*

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

Pharmacy information available at anthem.com

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

New provider directory indicator for telehealth services

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

New Anthem utilization management tool now available on Availity: Authorization Rules Lookup tool

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

Medical Policy and Clinical Guideline Updates - February 2021*

February 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2021

Reimbursement policy update: Emergency Room Transfers - Facility*

February 2021 Anthem Provider News - Wisconsin Reimbursement Policies Feb 1, 2021

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

February 2021 Anthem Provider News - Wisconsin Reimbursement Policies Feb 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

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

Register today for The Road to Allyship Forum hosted by Anthem and Motivo on February 3, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and the importance of allies.
The Road to Allyship Forum Invitation Administrative Jan 21, 2021

Important COVID-19 update: Prior authorization and other policy adjustments (Updated January 13, 2021)

Prior authorization requirements updated for patient transfers from acute inpatient hospitals to skilled nursing facilities.
COVID-19 Information - Wisconsin Administrative Jan 13, 2021

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated January 8, 2021)

We’ve updated information about coverage for telephonic-only care.
COVID-19 Information - Wisconsin Administrative Jan 8, 2021

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - January 2021

Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
January 2021 Anthem Provider News - Wisconsin Administrative Jan 1, 2021

IngenioRx introduces new pharmacy network in 2021

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

Prior authorization updates for specialty pharmacy are available - January 2021*

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

It is almost CAHPS survey time!

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

Evaluation and management changes 2021

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

Outpatient system updates for 2021 - Facility

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

Professional system updates for 2021

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

New features added to Interactive Care Reviewer

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

Procedure searches in Find Care: New sort option

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

Availity attachment tools for Anthem and affiliate payers - Live webinars

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

Self-service, digital transactions are fast and easy

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

Medical Policy and Clinical Guideline Updates - January 2021*

January 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2021

MCG Care Guidelines 24th Edition Customization*

January 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency editing - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 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
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