Key Updates
CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2025
You are invited: immunization measures webinar
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025
CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 23, 2025
Enhance care provider data accuracy with updated roster tools
CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Benefits of utilization management attestations: a guide for care providers
BadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Earn CME credits: Attend our engaging webinars
Recent Updates
Medicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listCommercialAugust 1, 2025
SUD confidentiality protections for membersCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2025
You are invited: immunization measures webinarCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideMedicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
BadgerCare Plus and Medicaid SSI ProgramsJuly 25, 2025
Precertification/prior authorization requirement changesEffective September 1, 2025
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 23, 2025
Enhance care provider data accuracy with updated roster toolsCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 18, 2025
New mandatory fields in roster templateBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Clinical Criteria updatesEffective August 3, 2025
CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Earn CME credits: Attend our engaging webinarsCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
Reimbursement policy update: Bundled Services and Supplies — ProfessionalCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 1, 2025
Update: National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
CommercialJune 25, 2025
Medical Policies and Clinical Guidelines updates — August 2025Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansCommercialBadgerCare Plus and Medicaid SSI ProgramsJune 17, 2025
National Drug Code required for professional and facility outpatient claimsMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesBadgerCare Plus and Medicaid SSI ProgramsJune 13, 2025
Precertification/prior authorization requirement changesEffective August 1, 2025
Medicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 3, 2025
National Drug Codes (NDC) are required for outpatient claimsCommercialJune 2, 2025
Specialty pharmacy updates: June 2025CommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialJune 1, 2025
Updated 2025 provider manual now availableBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2025
Learn about members’ rights and responsibilitiesCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2025
Submitting BH authorizations in Availity EssentialsBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2025
Navigating health with confidence through the Complex Case Management programCommercialJune 1, 2025
You are invited: claims appeals on Availity Essentials