Key Updates
CommercialMedicaidDecember 24, 2024
Availity Essentials maternity update for providers
MedicaidDecember 3, 2024
Guidance for blood lead level screening of young children
CommercialMedicare AdvantageMedicaidDecember 3, 2024
California DxF provider participation and accessing data for Anthem members
CommercialMedicare AdvantageMedicaidOctober 24, 2024
Time to prepare for HEDIS medical record review
Recent Updates
Medicare AdvantageMedicaidDecember 26, 2024
Prefix required on claim submissionsCommercialDecember 26, 2024
HEDIS Well Child and Immunizations Coding Bulletin 2025CommercialMedicaidDecember 24, 2024
Availity Essentials maternity update for providersCommercialDecember 24, 2024
HEDIS CAT II Coding Bulletin 2025Medicare AdvantageDecember 23, 2024
Specialty pharmacy precertification list expansionMedicare AdvantageDecember 23, 2024
Specialty Pharmacy Precertification and Step Therapy list expansionMedicare AdvantageDecember 19, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesMedicare AdvantageAMH - Medicare AdvantageDecember 16, 2024
Shortage of repackaged bevacizumab for ophthalmic useMedicaidDecember 3, 2024
Guidance for blood lead level screening of young childrenCommercialDecember 3, 2024
Outpatient system updates for 2025CommercialDecember 3, 2024
Professional system updates for 2025CommercialMedicare AdvantageMedicaidDecember 3, 2024
California DxF provider participation and accessing data for Anthem membersCommercialDecember 1, 2024
BlueCard Program useful tipsCommercialDecember 1, 2024
Case Management programCommercialDecember 1, 2024
PCP after‑hours access requirementsCommercialDecember 1, 2024
Reminder: Direct HMO is coming January 2025CommercialDecember 1, 2024
Pharmacy information available onlineCommercialDecember 1, 2024
Coordination of careCommercialDecember 1, 2024
Important update: Blue High Performance Network claims submission guidelines and provider informationCommercialDecember 1, 2024
Kroger Specialty Pharmacy acquisitionCommercialDecember 1, 2024
Paragon Healthcare joins our medical specialty pharmacy provider network in 2025CommercialDecember 1, 2024
FEP excited to join PSHB program in 2025CommercialDecember 1, 2024
Members’ Rights and ResponsibilitiesCommercialDecember 1, 2024
Streamlined medical necessity reviews: What you need to know for timely decisionsCommercialDecember 1, 2024
Appropriate 911/emergency care proceduresCommercialDecember 1, 2024
Clinical practice and preventive health guidelines available onlineCommercialDecember 1, 2024
Do you offer telehealth services? Let us know!CommercialDecember 1, 2024
CAA: Maintain your online provider directory informationCommercialDecember 1, 2024
Find answers to BlueCard questionsCommercialMedicare AdvantageDecember 1, 2024
Comprehensive, holistic care for obstructive sleep apneaMedicare AdvantageNovember 26, 2024
HEDIS Category II Coding Bulletin 2025CommercialNovember 25, 2024
Submitting authorization for NICU services facilitates accurate and timely claims processingMedicare AdvantageNovember 19, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Medicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicaidNovember 15, 2024
Targeted rate increase: updateMedicare AdvantageNovember 15, 2024
California 2025 Medicare Advantage plan changesMedicaidNovember 13, 2024
Updated provider manual now availableCommercialNovember 6, 2024
Cost transparencyCommercialMedicare AdvantageMedicaidNovember 1, 2024
Roster Automation updates: roster download functionalityMedicaidNovember 1, 2024
Bayer announces withdrawal of Aliqopa® (copanlisib)MedicaidNovember 1, 2024
Community Supports services: cost-effective alternatives for eligible membersCommercialNovember 1, 2024
Welcome to the Pathway HMO NetworkMedicaidNovember 1, 2024
Join the Medicaid Medical Advisory Committee to make an impact on healthcare qualityMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basics