Wisconsin
Provider Communications

May 2021 Anthem Provider News - Wisconsin

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Title Category

2021 Affirmative statement regarding utilization management decisions

Administrative

A helpful and complete guide to covered well-child visits

Administrative

Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care

Medicaid

Continuing medical education and continuing education unit opportunities

Medicaid

Digital online scheduling feature now available in the Availity Portal

Administrative

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
Medicare

Maximizing efficient, high quality COVID-19 screenings

Medicare

May is National High Blood Pressure Education Month

Administrative

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
Medicaid

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

Medicaid

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

Medical Policy & Clinical Guidelines

New prior authorization requirement: Kidney transplantation*

*Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - May 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.
Administrative

Provider bulletins for medical and itemized bill attachments: Electronic solutions at your fingertips

Administrative

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

Administrative

Reimbursement policy reminder: Readmission - Facility

Reimbursement Policies

Reimbursement policy update: Frequency editing - Professional

Reimbursement Policies

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

*Material Adverse Change (MAC)
Reimbursement Policies

Reimbursement policy update: Multiple and bilateral surgery - Professional and Facility

Medicaid

Resources to support diverse patients and communities

Administrative

Retraction: AIM Rehabilitative program - initial evaluations and site of service reviews

Medicaid

Sending larger digital attachments through Availity

Administrative

Sign up to receive email from Anthem Blue Cross and Blue Shield

Medicaid

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization*

*Material Adverse Change (MAC)
Pharmacy

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Updated 2021 Provider Manual now available

Administrative

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews RETRACTION - Please refer to article published May 4, 2021

Medical Policy & Clinical Guidelines

Updates for specialty pharmacy are available - May 2021*

*Material Adverse Change (MAC)
Pharmacy
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