CommercialMedicare AdvantageMedicaidDecember 1, 2023
December 2023 Provider Newsletter
Featured Articles
CommercialDecember 1, 2023
CarelonRx, Inc. Mail will change to CarelonRx Pharmacy on January 1, 2024
CommercialDecember 1, 2023
Benefit enhancements for CalPERS PPO members
MedicaidNovember 20, 2023
Access to new and improved services
MedicaidDecember 1, 2023
Reminder: Balance billing prohibited
Medicare AdvantageDecember 1, 2023
Model of care training reminder
Administrative
CommercialDecember 1, 2023
New vendor administering behavioral health access surveyCommercialDecember 1, 2023
Outpatient system updates for 2024CommercialDecember 1, 2023
Professional system updates for 2024CommercialMedicare AdvantageMedicaidDecember 1, 2023
New requirements for credentialing and recredentialingCommercialDecember 1, 2023
Case Management ProgramCommercialDecember 1, 2023
Coordination of careCommercialDecember 1, 2023
CAA: Review your online provider directory informationCommercialDecember 1, 2023
An overview of our medical necessity review processMedicare AdvantageDecember 1, 2023
2024 Medicare Advantage service area and benefit updatesCommercialDecember 1, 2023
Contract compliance with accessibility standards for Appointment Availability and Emergency Care instructions After Hours CareCommercialDecember 1, 2023
Clinical practice and preventive health guidelinesCommercialDecember 1, 2023
Members’ Rights and ResponsibilitiesCommercialDecember 1, 2023
Clinical Documentation Lookup ToolMedicaidDecember 1, 2023
Filing digital claims disputes: Transparent and trackableBehavioral Health
CommercialDecember 1, 2023
Find answers to BlueCard questionsCommercialDecember 1, 2023
BlueCard Program quick tipsCommercialDecember 1, 2023
Practice status: open or closedCommercialDecember 1, 2023
Does your practice offer telehealth services? Let us know!CommercialDecember 1, 2023
Timely Access Regulations and Language Assistance ProgramEducation & Training
Medicare AdvantageNovember 28, 2023
2024 Medicare Advantage California EAE DSNP ChangesMedicaidNovember 13, 2023
Population Needs Assessment Provider BulletinPolicy Updates
MedicaidNovember 21, 2023
Medical Policies and Clinical Utilization Management Guidelines update for May 2023Medicare AdvantageNovember 21, 2023
Medical Policies and Clinical Utilization Management Guidelines update for May 2023Medicare AdvantageDecember 1, 2023
Glucagon-Like Peptide-1 prior authorization changesMedicare AdvantageNovember 17, 2023
Transition to Carelon Medical Benefits Management, Inc. Genetic Testing GuidelinesMedicaidNovember 7, 2023
Carelon Medical Benefits Management, Inc. updatesMedicare AdvantageNovember 15, 2023
Prior authorization requirement changes effective May 1, 2024Codes 0738T and 0739T
Medicare AdvantageNovember 15, 2023
Prior authorization requirement changes effective May 1, 2024Codes Q4272 - Q4284
Medicare AdvantageNovember 8, 2023
Prior authorization requirement changes effective May 1, 2024Code E0761
Medicare AdvantageOctober 31, 2023
Prior authorization requirement changes effective March 1, 2024Codes 33275 and 33274
Products & Programs
CommercialDecember 1, 2023
Federal Employee Program updates member ID cardsCommercialDecember 1, 2023
2024 Federal Employee Program benefit information available onlineCommercialMay 31, 2023
Pharmacy information available on our provider websiteMedicare AdvantageOctober 26, 2023
Notification of specialty pharmacy medical step therapy updatesQuality Management
CommercialMedicare AdvantageMedicaidNovember 10, 2023
HEDIS 2023 Electronic Clinical Data Systems (ECDS)CABC-CDCRCM-045262-23
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