CommercialMedicare AdvantageMedicaidApril 1, 2024

April 2024 Provider Newsletter

Featured Articles

Education & TrainingCommercialApril 1, 2024

Blue High Performance Network

Administrative

AdministrativeCommercialApril 1, 2024

HCPCS to revenue code alignment for behavioral health

AdministrativeCommercialApril 1, 2024

Emergency department protocol for Special Investigation Unit review

AdministrativeCommercialApril 1, 2024

Review your online provider directory information

AdministrativeCommercialApril 1, 2024

Termination of Anthem mailboxes — replaced by use of Availity Essentials

Digital SolutionsCommercialApril 1, 2024

Home Health Agency Capabilities Survey

Education & Training

Education & TrainingCommercialMedicare AdvantageMedicaidApril 1, 2024

April is National Minority Health Month and Stress Awareness Month

Education & TrainingCommercialMarch 12, 2024

Important reminder: The correct original claim number must be included if submitting a corrected claim

Education & TrainingCommercialApril 1, 2024

Anthem contraceptive coverage notice

Education & TrainingMedicaidApril 1, 2024

New digital learning platform

Policy Updates

Policy UpdatesMedicaidMarch 26, 2024

Carelon Medical Benefits Management, Inc updates

Medical Policy & Clinical GuidelinesMedicaidMarch 18, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 4, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Prior AuthorizationMedicare AdvantageMarch 19, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationMedicaidFebruary 29, 2024

Prior authorization requirement changes effective June 1, 2024

Prior AuthorizationMedicare AdvantageMarch 11, 2024

Prior authorization requirement changes effective July 1, 2024

Products & Programs

PharmacyMedicare AdvantageMarch 22, 2024

Expansion of specialty pharmacy precertification list

PharmacyCommercialApril 1, 2024

Pharmacy information available on our provider website

PharmacyMedicaidMarch 22, 2024

Prior authorization updates for medications billed under the medical benefit

Elrexfio, Ngenla, Pombiliti, Talvey, Tyruko, Veopoz, and Ycanth

PharmacyMedicaidMarch 6, 2024

Prior authorization updates for medications billed under the medical benefit

Elfabrio, Epkinly, Qalsody, Vyjuvek, and Zynyz

Quality Management

Quality ManagementCommercialMedicare AdvantageMedicaidMarch 8, 2024

HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)

CABC-CDCRCM-053234-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).