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Information for Wisconsin







Provider Education and Training

At Anthem, we are continually developing new ways to work collaboratively with health care professionals like you. The mission of our Provider Education Team is to improve working relationships with our provider partners through the development and delivery of communications and educational programs that foster best practice opportunities. These complimentary programs are also a great way to stay current on changes and updates at Anthem.

Working with Anthem® Webinar Series

Learn what tools are available to you at Anthem and how to use them with our 2023 Subject Specific Webinars. If you are interesting in attending a webinar, please subscribe to our email distribution list here.

Seminars and Webinars

Webinar | 45 minutes | New providers; registration and billing staff
 
This webinar will help you understand the Blue System and how the independent Blue
plans work together. It will introduce you to the BlueCard® Program. We will help you
understand the concepts of the member’s plan (Home) and local plan (Host) along with
Blue plan responsibilities.
 
Webinar | 30 minutes | New providers; billing and reconciliation staff 
 
This webinar will help you understand why and how Anthem notifies you of a claim overpayment. You’ll learn how to respond to refund requests along with tools you can use to reconcile accounts that have been off-set by a claim recoupment.
 
Webinar | 90 minutes | New providers; registration, clinical and billing staff 

This webinar will introduce you to all the electronic tools you can use to streamline the efficiency of your organization. We will discuss:
• Anthem’s public provider websites
• Availity’s secure multi-payer portal for member eligibility, benefits, claim status and Anthem-specific functionality
• Electronic claims, payments and remittance advice
• Interactive Care Reviewer (ICR) for medical precertification and predetermination for local Anthem members
• Online precertification for services medically managed by AIM Specialty Health® (AIM), including but not limited to: diagnostic imaging, cardiology, genetic testing, musculoskeletal, radiation therapy, sleep management (testing and therapy), upper gastrointestinal endoscopy (esophagogastroduodenoscopy (EGD)), and specialty pharmacy for local Anthem members

Working with Anthem - Go Digital E-Tools for Providers presentation

Webinar | 30 minutes | New providers responsible for receiving and sending medical records
 
This webinar will help you understand why and how medical records are requested for local Anthem and BlueCard® Program members. You will learn what you can do to ensure the information you send is complete, can be connected to the request for review timely and how to submit records requested by Anthem via the Medical Records Attachment functionality through Availity®.
 
Webinar | 75 minutes | New providers; registration staff 
 
This webinar will help you understand member identification cards. You will learn about the Anthem products offered in Wisconsin and how to distinguish between the member’s product (benefit) and the provider’s network (reimbursement). We’ll show you the different tools that can be used to verify member eligibility and benefits.
 
Webinar | 90 minutes | New providers; registration and clinical staff 
 
This webinar will help you learn how to find precertification requirements for local Anthem and BlueCard® Program members. Learn how to precertify services medically managed by AIM Specialty Health® (e.g. diagnostic imaging, cardiology, genetic testing, musculoskeletal, radiation therapy, sleep management (testing and therapy) and specialty pharmacy) online for local Anthem members. The webinar will also introduce you to the Interactive Care Reviewer (ICR) that can be used for medical precertification and predetermination for local Anthem Plan members).
 
Webinar | 75 minutes | New providers responsible for claim submission and payment reconciliation
 
This webinar will help you learn the most expedient ways to submit new, corrected and secondary payer claims to Anthem and how to avoid some common submission errors. Did you ever wonder what happens to a claim once you submit it? We’ll show you how to check the status of your claims, view your remittance advice, and submit secure messages questioning a claim online. You will learn where to find medical policies for all Blue members, Anthem clinical claim edits, reimbursement policies and the difference between a complaint and an appeal. 
 
Webinar | 45 minutes | Providers and staff
 
Find out you can expect from Anthem this year. You’ll learn about what is and is not changing and what your office needs to do in response. We’ll also introduce our new digital tools that will save you time and increase productivity.
 
Ready to become a provider in the Anthem network?

We look forward to working with you to provide quality service for our members.

Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place.
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